36C25725R0095.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

504-26-1-404-0001

519-26-1-359-0001

36C25725R0095 09-26-2025

Mariangie Rios Vazquez 210-996-8816 10-13-2025 2:00pm CDT

Department of Veterans Affairs Network Contracting Office 17 5441 Babcock Road Ste. 302 San Antonio TX 78240

X 100

X

621910

$22.5 Million

N/A

X

Amarillo VA Health Care System 6010 Amarillo Boulevard See Schedule for addtional locations

West Amarillo TX 79106

Same as block 16.

This is accomplished through the Tungsten Network located at:

http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices.

(877) 353-9791 (512) 460-5540

See CONTINUATION Page

Air Ambulance Transportation Services IAW PWS.

The Contractor will provide 24/7 ALS/CCT pre-arranged Air Ambulance Services including all holidays.

All documentation for offer submission are due on Monday October 13, 2025 at 2:00PM CST.

Please submit all questions no later than Monday October 6 2025 by 2:00PM CST.

No questions will be answered by telephone call.

Offerors are required to sign and return SF1449 solicitation document and its subsequent amendments.

Attached are the applicable Service Contract Act Wage Det.

SCA WD 15.5213 rev. 28 - Amarillo SCA WD 15-5269 rev. 29 – Big Spring

See CONTINUATION Page

X X

X 1

Astrid McKinney Contracting Officer

36C25725R0095

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

B.4 STATEMENT OF WORK

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.2 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.3 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025)

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.9 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.10 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.11 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 62

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

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

1998)

E.2 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.6 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.7 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

E.9 52.216-1 TYPE OF CONTRACT (APR 1984)

E.10 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

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: TBD

b. GOVERNMENT: Contracting Officer 36C257 Astrid McKinney

Department of Veterans Affairs

Network Contracting Office 17

5441 Babcock Road

Ste. 302

San Antonio TX 78240

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

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

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

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:

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION

OF SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 YR __________________ __________________

Air Ambulance Big Springs; BLS Non-Emergent Transport (ONE

WAY). The Contractor will provide pre-arranged Air Ambulance Transportation Services twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the BS VA.

Provide pricing for each of the locations below:

Albuquerque, NM $ Dallas, TX $ San Antonio, TX $ Amarillo, TX $ El Paso, TX $ Lubbock, TX $ Oklahoma City, OK $ Tucson, AZ $

Period of Performance (POP):

POP Begin: 11-11-2025 POP End: 11-10-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services

PRODUCT/SERVICE CODE: V225 -

Transportation/Travel/Relocation - Travel/Lodging/Recruitment:

Ambulance

1.00 YR __________________ __________________

Air Ambulance Amarillo; BLS Non Emergent Transport (ONE

WAY). The Contractor will provide pre-arranged Air Ambulance Transportation Services twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the AMA

VA.

Provide pricing for each of the locations below:

Albuquerque, NM $ Dallas, TX $ San Antonio, TX $ Big Spring, TX $ El Paso, TX $ Lubbock, TX $ Oklahoma City, OK $ Tucson, AZ $ Houston, TX $

Period of Performance (POP):

POP Begin: 11-11-2025 POP End: 11-10-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services

PRODUCT/SERVICE CODE: V225 -

6.00 MO __________________ __________________

Extension IAW 52.217-8 Option to Extend Services. Air Ambulance

Big Springs; BLS Non Emergent Transport (ONE WAY). The Contractor will provide pre-arranged Air Ambulance Transportation Services twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the BS VA.

Provide pricing for each of the locations below:

Albuquerque, NM $ Dallas, TX $ San Antonio, TX $ Amarillo, TX $ El Paso, TX $ Lubbock, TX $ Oklahoma City, OK $ Tucson, AZ $

Option to Extend IAW FAR 52.217-8 POP Begin: 11-11-2026 POP End: 02-10-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services

PRODUCT/SERVICE CODE: V225 -

6.00 MO __________________ __________________

Extension IAW 52.217-8 Option to Extend Services. Air Ambulance

Amarillo; BLS Non Emergent Transport (ONE WAY). The Contractor will provide pre-arranged Air Ambulance Transportation Services twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the AMA VA.

Provide pricing for each of the locations below:

Albuquerque, NM $ Dallas, TX $ San Antonio, TX $ Big Spring, TX $ El Paso, TX $ Lubbock, TX $ Oklahoma City, OK $ Tucson, AZ $ Houston, TX $

Option to Extend IAW FAR 52.217-8 POP Begin: 11-11-2026 POP End: 02-10-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services

PRODUCT/SERVICE CODE: V225 -

GRAND TOTAL __________________

B.3 DELIVERY SCHEDULE

ITEM NUMBER SHIPPING INFORMATION QUANTITY

0001 and 0003 SHIP TO: West Texas VA Health Care System 300 Veterans Blvd.

Big Spring, TX 79720

USA

All

MARK FOR: Davila, Sara J.

(432) 263-7361 7623 sara.davila@va.gov

0002 and 0004 SHIP TO: Amarillo VA Health Care System 6010 Amarillo Boulevard West Amarillo, TX 79106

USA

All

MARK FOR: Ramirez, Julio 806-355-9703 ext. 4546 Julio.Ramirez3@va.gov

B.4 STATEMENT OF WORK

1. Background: The West Texas VA Health Care System (WTVAHCS) and the Amarillo VA Health Care System (AVAHCS) Vehicle Transportation Programs (VTP) have consolidated the Air Ambulance Service requirement for the past 5 years. This requirement has provided Veterans with transportation to VA facilities and care centers throughout the nation to receive lifesaving surgeries and treatment.

2. Purpose: The WTVAHCS and AVAHCS VTP programs require the services of fixed wing air transport of Veteran patients to higher echelon care facilities.

3. Scope The Contractor will provide Advanced Life Support (ALS), Critical Care Transport(CCT) with pre-arranged air ambulance service twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the VA. For the purpose of this Contract, patients shall be transported by Air Transport only if the patient requires continuous electrocardiogram, ECG monitoring and/or the physician designates a patient as a critical care transport. It is further understood that only a physician or registered nurse with critical care training and current advanced cardiac life support must be designated as the medical flight attendant, in accordance with the standards of the Commission on Accreditation of Medical Transport System (CAMTS), Medical Transport and Medical Escort Accreditation (NAAMTA Global), or European Aero Medical Institute (EURAMI) for any critical care transport.

3.1 Air ambulance flights are expected to be one-way trips (patient onboard only) if the authorized beneficiary is transferred to another VA or non-VA facility. If a return Air Ambulance service would be required, it would be the responsibility of the sending VA medical center to provide this under their current contracts.

3.2 It is understood that only one VA patient will be transported on a trip unless multiple VA patients are specifically authorized by the VA. When more than one VA patient is transported on a trip, reimbursement shall be made at the rate not exceeding the cost of transporting a single patient; however, the longest distance over which a patient is transported may be claimed when more than one VA patient is transported in a single airplane concurrently. Under no circumstances will the VA order air ambulance service for more than two VA passengers for any one flight. The contractor is expected to accept all patients (regardless of physical or mental health condition) but has the right to refuse when in the best interest of the safety of the patient. The contractor will not accept any patient unless the VA case manager or other assigned designee authorizes the flight. The VA case manager or assigned designee will inform the contractor regarding all medical treatment or care requirements for each patient (such as the administration of oxygen or medication).

3.3 In the event the contractor is unable to support the request for patient pick-up service, it shall be the responsibility of the contractor to make arrangements with another air carrier to provide equivalent transportation. The cost for the alternate service with the replacement air carrier shall be borne by the contractor. The alternate service provider shall submit all bills for reimbursement to the contractor directly.

Reimbursement can be submitted on the next monthly invoice; however, the government will pay no more than the contract-negotiated rate.

3.4 Response Time/Waiting Time:

3.4.1. Response Time: The contractor shall be enroute to provide transportation within one (2) hour of request from the VA facility.

3.4.2. Waiting Time: The contractor shall not be expected to wait more than one (1) hour for patients coming to the VA without receiving further payment. Delays due to causes beyond the control and without the fault of the VA for the beneficiary patient concerned shall not be considered waiting time. Such causes may include but are not restricted to, acts of God or of the public enemy, fires, floods, epidemics, quarantine restrictions, strikes, freight embargoes, or delays caused by weather conditions.

3.5 Ground Ambulance Coordination: If a VA facility does not have availability through a VA ambulance service for ground transportation, the contractor is responsible for coordinating ground ambulance services to provide continuity of transportation, the air ambulance operator will coordinate aircraft departures and arrivals with required surface transportation to avoid any delays at the points of origin and flight destination. If a delay is unavoidable, the patient must be protected from inclement weather, including temperatures that could adversely affect their conditions.

NOTE: The Air Ambulance Medical Team shall provide a bedside-to-bedside continuum of care for all patients.

1. SPECIFIC to Amarillo VAHCS: During regular business hours, the air ambulance provider will utilize the Amarillo VA ambulance to transport patients to and from the air ambulance provider’s location when at an airport within 25 miles of the Amarillo VA hospital. Coordination of the Amarillo VA Ambulance will be done by the ordering clinical staff at the Amarillo VA. If the VA ambulance is not available for transport, the Contractor will coordinate alternative ambulance transportation as part of continued care.

NOTE: Normal business hours (VAMC Travel Department) are Monday through Friday, 7:00 AM to 4:30 PM Local Time, excluding federal holidays.

3.6. PLACE(s) OF PERFORMANCE:

West Texas VA Health Care System Amarillo VA Health Care System

George O' Brian Department of Veterans Affairs Medical Center

Thomas E. Creek Department of Veterans Affairs Medical Center

300 West Veterans Boulevard 6010 Amarillo Boulevard, West

Big Spring, TX 79720 Amarillo, TX 79106-1991

3.7 Patient Medical Records:

The contractor shall maintain for a period of five (5) years, a record of each air ambulance operation, including but not limited to the following:

(1) Patient’s name.

(2) Date of flight.

(3) Diagnosis.

(4) Originating and termination points and patient’s condition upon departure and arrival.

(5) An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, and details of therapeutic intervention. (These notes can be vitally important to those who must provide subsequent care.)

(6) Unusual circumstances encountered during the flight, including inordinate altitudes flown, turbulence, times associated with these abnormal conditions, etc.

3.8 Operational Requirements:

3.8.1. Within three (3) business days after award and notification, the successful offer shall supply certifications, competencies, and qualifications with a list of all the personnel and their titles that will be involved in the performance of the resulting contract. Also included must be the names and telephone numbers of dispatchers.

3.8.2. Contractor shall hold a valid Air Carrier Operating Certification issued by the Federal Aviation Agency (FAA), for an Air taxi operator, a copy of which will be submitted with the bid. The operations authorized under this certificate shall be such that he/she can perform the services required by this contract. The contractor shall abide by all applicable FAA regulations. The contractor shall hold a valid commercial airman’s certificate with the appropriate ratings for the conditions of the flight being undertaken and operate under the air taxi rules for that certificate. The contractor shall be, and must maintain all CAMTS, NAAMTA Global, or EURAMI accreditations. The contractor must comply with all applicable, Federal, State, and Local Regulations governing the operation of an Air Ambulance service.

3.8.3. An FAA flight plan shall be filed for any aircraft used for an air ambulance flight under this contract. Wherever practical and possible, the pilot shall take advantage of all existing ground and air communication facilities. Before each flight, the pilot shall obtain the latest information relative to weather, airport conditions, and navigational facilities and, further, shall be satisfied that all conditions are such that they will not constitute a hazard. In the event a flight is interrupted short of the destination, the contractor shall immediately notify the VA Facility POC requesting the transport and make necessary arrangements.

3.8.4. All operations under the contract must be supervised by competent trained personnel who adhere to safe practices. Definite precautions shall be taken to keep passengers and spectators away from the aircraft when the power is on. All facilities, including ramps, ramp areas, building passenger areas, etc., shall be maintained in a clean and orderly condition, free from debris and any accumulation which may constitute an accident or fire hazard. The patient should be sufficiently isolated from the cockpit to minimize in-flight distractions and interference, which would affect flight safety.

3.8.5. Passengers shall not be allowed to board aircraft when engines are running.

3.8.6. The contractor will staff each air ambulance with an aircrew consisting of at least the minimum standard personnel required by the FAA and the Texas Department of Health. A medical doctor may be substituted for the attendant.

Additional contractor team members may accompany the aircrew at the discretion of the contractor, at no additional cost to the VA.

3.9 Information Relayed Between Pilot and Medical Attendant:

3.9.1. As a minimum, the pilot will provide the following information to the Medical Flight Attendant:

a. ETA (Estimated Time of Arrival).

b. Planned flight altitude.

c. Significant and/or expected weather.

3.9.2. The Medical Flight Attendant will provide, at a minimum, the following information to the pilot:

a. Brief appraisal of the patient’s problem and condition.

b. Patient’s environment needs, e.g., pressurization, temperature, etc.

c. Significant changes in the patient’s condition during flight.

d. Care/medication administered during flight.

3.10 All work related to this contract shall be performed in accordance with any applicable Federal Aviation Administration (FAA), U.S. Department of Transportation (DOT), Occupational Safety and Health Administration (OSHA) regulations, as well as applicable State health and safety regulations.

All aircraft used in the performance of this agreement must be maintained in an airworthy condition in accordance with all applicable FAA Regulations and procedures by means of an established inspection and maintenance plan. Line inspections shall be performed at least once in the twenty-four (24) hour period preceding a flight. Aircraft shall be handled exclusively by trained personnel. Additionally, the contractor shall also provide preventative maintenance inspections of the aircraft to be used for the provision of these services, as required by the FAA on a monthly basis to the Contracting Officer Representative (COR) or designee.

3.10.1 The solicitation and subsequent contact include FAR 52.222-41, Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the Contractor's responsibility to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the

SCLS.

VA reminds contractors of the Department of Labor Regulations which implement the Service Contract Labor Standards, (SCLS) and which read at 29 CFR § 4.155:

Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee. Thus, for example, a person's status as an “owner-operator” or an “independent contractor” is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.

3.11 The Government intends to make one award. The resulting contract made against this solicitation will be an Indefinite Delivery Indefinite Quantity (IDIQ) firm-fixed price contract.

3.12 Period of Performance is estimated to be for one (1) year.

3.13 The following chart includes the estimated trips per year along with the guaranteed minimum amount per one-way trip. These guaranteed amounts apply to ordering periods as well. The minimum guarantee will be included in the first funded task order that is awarded against the IDIQ contract.

Description 12 Month

Estimate Minimum Maximum

Air ambulance services for Amarillo VA, Station 504

12 one-way trips $1,000.00 NTE: Available funding on the awarded contract

Air ambulance services for Big Spring VA, Station

2 one-way trips $1,000.00 NTE: Available funding on the awarded contract

Primary Transport Destinations:

Origin Destination Flying Miles

Big Spring TX Albuquerque NM 356 Dallas TX 276 San Antonio TX 263 Amarillo TX 206 El Paso TX 296 Lubbock TX 94 Oklahoma City OK 318 Tucson AZ 556 Houston TX 401 Amarillo Albuquerque NM 273 Dallas TX 334 San Antonio TX 445 Big Spring TX 206 El Paso TX 359 Lubbock TX 113 Oklahoma City OK 244 Tucson AZ 566 Houston TX 533

4. General Requirements:

4.1 Non-Personal Services: The Government will neither supervise contractor employees nor control the method by which the contractor performs the required tasks. Under no circumstances will the Government assign tasks to, or prepare work schedules for, individual contractor employees. It shall be the responsibility of the contractor to manage its employees and to guard against any actions that are of the nature of personal services or give the perception of personal services. If the contractor believes that any actions constitute, or are perceived to constitute personal services, it shall be the contractor's responsibility to notify the Contracting Officer (CO) immediately.

4.2 Business Relations: The contractor shall successfully integrate and coordinate all activities needed to execute the requirement. The contractor shall manage the timeliness, completeness, and response to quality deficiencies identified. The contractor shall provide corrective action plans, proposal submittals, effective management of subcontractors, and the timely identification of issues which should be reported no later than 24 hours after they are noticed. The contractor shall seek to ensure customer satisfaction and professional and ethical behavior of all contractor personnel.

5. Contract Administration and Management:

5.1 Designation of Contracting Officer Representative (COR)

5.1.1 The Contracting Officer (CO) will appoint a COR to perform tasks related to the execution and surveillance of this contract. The COR will be designated to represent the CO in furnishing technical guidance and advice under this contract.

The foregoing is not to be construed as authorization to interpret or furnish advice and information to Contractor relative to the financial or legal aspect of the contract. Those matters are the responsibility of the CO and will not be delegated.

5.1.2 The CO is responsible for the administration of this contract. The CO is the only individual authorized, to extent indicated in this contract, to take actions on behalf of the Government, which may result in changes in the contract terms, to include deviation from the statement of work, details, and performance schedules.

Communications pertaining to contractual matters shall be addressed to the CO.

No changes in or deviation from the scope of work shall be affected without a written modification to the contract executed by the CO. No oral statements of any person whosoever will in any matter or degree, modify or otherwise affect the terms of this contract.

5.1.3 The Contractor will receive a copy of Delegation Letter which will identify the COR appointed by the CO. The COR will be included on all communications between the contractor and the Contracting Officer, and the COR shall be responsible for the validation/reconciliation of claims and authorization for payment.

5.2 Orders:

5.2.1 Ordering officers (OOs) will be authorized to place orders under this contract.

Fulfilling orders from persons other than the CO or OO may result in loss or delay in payment for supplies/services provided under such orders. Locally approved clinical staff will be responsible for requesting flights on behalf of the VA provider and entry of the required Interfacility Transfer Order in the Computerized Patient Record System (CPRS).

NOTE: When VA activates and mandates the use of the VetRide Third Part Portal or VA approved transportation software, orders will be placed via that system if possible. All requests for services made during normal business hours will be made via the VetRide Third-Party Portal or VA-approved transportation software. Outside of normal business hours, requests may be made via the VetRide Third-Party Portal or VA-approved transportation software, in writing, or by telephone. If the request is made by telephone, written documentation of the request and response and response time will be provided to the Mobility Manager or the VA Transportation Coordinator within the first three (3) hours of the next business day.

5.2.2 An authorization number will be provided at the start of each Base and Option year which should be in the following format 504 or 519C#####. The Contractor will submit invoices through the defined payment processing method with the following sequencing 504 or 519C#####-001, 002, 003, …

5.2.3 The Contractor will commence the flight at the scheduled times unless prevented from doing so by conditions outside of the contractor’s control (weather, national emergency, etc.) in which case the contractor must immediately notify the Veterans Transportation Service (VTS) Mobility Manager or designee.

5.2.4 The VA Clinical Provider requesting an air ambulance is responsible for identifying a medical justification for an air ambulance transport and delineating the medical care of the patient during transport. Medical orders will be issued upon patient pick-up as well as a travel authority. It is the provider’s responsibility to complete the delivery of transfer paperwork to the receiving facilities’ accepting patients.

5.2.5 Orders, requests, or changes to transportation requests will only be made by authorized VA officials as specified by the VA. Under no circumstances is there to be any deviation on request of any other party. In addition, no deviation will be made by the Contractor.

5.2.6 Only designated personnel of the VA Administration are authorized to order the contract services.

5.2.7 The contractor will be provided with a list of individuals authorized to request transportation services. Individuals not on this list are not authorized to order services. The Government will not be responsible for persons requesting services who are not on the list. The COR will furnish the contractor with the names of individuals delegated OO authority by separate letter upon issuance of the contract or agreement. When CORs appoint OOs after award, the COR will furnish the contractor with an updated list of individual OOs authorized to place orders against the contract or agreement. OOs may not negotiate contract terms and conditions, determine price reasonableness, or determine best value. OOs are responsible for issuing and administering orders placed under the contract or agreement identified in the appointment letter. OOs do not have authority to modify any of the terms and conditions in the contract or agreement.

5.2.8 The contractor shall accept orders against the contract or agreement only from the CO or authorized OOs and fulfilling orders from persons other than the CO or OO may result in an unauthorized commitment.

5.2.9 Payment will be based upon air mileage per actual loaded (patient onboard) miles flown and is expressed in statute miles (not nautical miles). In case a circuitous route must be employed for reasons of safety (such as unfavorable terrain or weather), a copy of the flight log showing with justification necessitating the detour from the most direct route will be provided to the VA as an itemized list if any additional charges are warranted.

6.0 Price/Cost Schedule - SAMPLE CLIN Structure.

ITEM INFORMATION

CLIN Description Estimated

Annual Quantity

Unit Price/ Flight

A0001 Amarillo -Air Ambulance Flight

12 LIN will be funded based on estimates.

A0002 Big Spring – Air Ambulance Flight

2 LIN will be funded based on estimates.

6.1 Rate: Line item is a rate per trip. No additional mileage.

6.2 This is a firm-fixed price contract. Quoted rates listed in Section B.2 Price

Schedule shall not be modified. Additional charges for sub-contractor services, to transport the plane to the origin destination, or for transport after final destination are not authorized under this contract. In addition, the Government shall not receive any invoices from sub-contractors. There is no privity of contract between the Government and any sub-contractors.

6.3 Cancellation: If the order is cancelled by the Requesting Physician, VAPAHCS, the Contractor will be paid the base rate plus actual nautical miles traveled at the time of the cancellation, plus the necessary nautical miles the Contractor’s aircraft must travel to return to its starting location. The return mileage is only reimbursable if the contractor does not have another destination on its flight plan.

7 Contractor Licenses and Permits: The contractor shall obtain all necessary licenses and/or permits required to perform this work. He/she shall take all reasonable precautions necessary to protect persons and property from injury or damage during the performance of this contract. He/she shall be responsible for any injury to himself/herself, his/her employees, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his/her employees’ fault or negligence and shall maintain personal liability and property damage insurance having coverage for a limit as required by the laws of Texas Furthermore, it is agreed that any negligence of the Government, its officers, agents, servants, and employees, shall not be the responsibility of the contractor hereunder with the regard to any claims, loss, damage, injury, and liability resulting there from.

7.1 Contract Management: The contractor shall establish clear organizational lines of authority and responsibility to ensure effective management of the resources assigned to the requirement. The contractor must maintain continuity between VA Amarillo and Big Spring ongoing operations and the contractor's corporate offices.

7.2 Contract Administration: The contractor shall establish processes and assign appropriate resources to effectively administer the requirement. The contractor shall respond to Government requests for contractual actions in no later than three business days. The contractor shall have a single point of contact between the Government and Contractor personnel assigned to support contracts or task orders. The contractor shall assign work effort and maintaining proper and accurate time keeping records of personnel assigned to work on the requirement.

7.3 Personnel Administration: The contractor shall maintain the proficiency of their employees by providing initial and refresher training as required to meet the PWS requirements. The contractor shall provide administrative support to employees in a timely fashion (time keeping, leave processing, pay, emergency needs).

7.4 Contractor Personnel, Disciplines, and Specialties: The contractor shall accomplish the assigned work by employing and utilizing qualified personnel with the necessary combination of education, training, and experience, as required by the FAA. The contractor shall match personnel skills to the work or task with a minimum of under/over employment of resources. The Contractor shall provide the necessary resources and infrastructure to manage, perform, and administer the contract.

7.5 Contractor Identification: Contractor personnel shall wear the Contractor's ID badge at all times with name clearly visible and it shall be consistent with the Contractor’s personnel roster.

8. VA Normal Business Hours: VA Amarillo and Big Spring normal business hours are Monday through Friday, from 07:00 AM to 4:30 Local Time, excluding the Federal Holidays as listed below:

a. New Year’s Day

b. Martin Luther King Jr. Day

c. President’s Day

d. Memorial Day

e. Juneteenth

f. Independence Day

g. Labor Day

h. Columbus Day

i. Veteran’s Day

j. Thanksgiving Day

k. Christmas Day

And any other day specifically declared by the President of the United States to be a national holiday.

9. Additional Requirements:

9.1 VetRide or VA-Approved Transportation Software Utilization and Invoicing:

The contractor agrees to utilize the VetRide Third Party Portal and Contractor Pass or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Third-Party Portal or VA-Approved Transportation Software for the contractor/contractor in this contract.

The Contractor will utilize the VetRide Third-Party Portal or VA-Approved Transportation Software fully as instructed:

a) Receive and respond to electronic trip requests.

b) Receive, use, and ensure the use of the Contractor pass by the dispatcher and aircrew.

c) Submit claims via the electronic HCFA 1500 in the VetRide Third-Party

Portal or VA-Approved Transportation Software system.

Invoice Deliverables: The contractor’s invoice must be on the HCFA 1500 to include:

(A) Contract Number and Purchase Order Number

(B) Federal Tax ID

(C) Submission date

(D) Date of flight and number of statute miles flown

(E) Authorization number(s)per order

(F) Pick-up and drop-off location of the patient

(G) Name and phone number of the authorized ordering Patient Travel

Coordinator and Facility.

(H) Originating and termination points

(I) Name, Date of Birth, and social security number of each patient

(J) An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, details of therapeutic intervention, and the names and qualifications of all attendants working under the delivery order.

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

(L) Contract line-Item number and associated Flight Rate (M)Name and phone number of the authorized ordering Patient Travel

Coordinator and facility.

(N) Originating and termination points.

(O) Name and social security number of each patient.

(P) Name(s) of ambulance companies providing ground transportation.

(Q) An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, details of therapeutic intervention, and the names and qualifications of all attendants working under the delivery order.

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

(S) Documentation of circumstances when billing for waiting time

(T) VA authorizing official’s name

(U) Healthcare Procedure Coding System/National Level II (HCPCS)

Unauthorized charges will be suspended by the COR. Unauthorized charges are those that have not been pre-approved by authorized VA personnel. Supporting documentation may be provided and submitted for payment consideration.

Suspended charges will be reviewed by the COR as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.

9.2. Health Insurance Portability and Accountability Act (HIPAA), Privacy Rule, and Security Rule:

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

Business Associate Agreement with their quotation (as provided as an attachment to this solicitation).

The contractor staff shall sign and follow confidentiality statements as required.

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

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

Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COTR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access.

Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract.

Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $37.50 per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:

(1) Notification.

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

(3) Data breach analysis.

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

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

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

9.3. Patient Privacy and Confidentiality:

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

9.4 Smoking Regulations and Precautions: In accordance with VA smoking policy and FAA regulations, no smoking will be allowed in the aircraft. Contractor shall comply with Federal Aviation Regulation 135.91b which prohibits smoking within 10 feet of oxygen storage and dispensing equipment carried on aircraft.

9.5 Ambient Control: The aircraft should have the capacity of maintaining the cabin temperature at about 75⁰ Fahrenheit, or as per FAA regulations during all phases of operation.

9.6 Communication System: The aircraft must have radio capability to communicate air to ground and air to air which meets/exceeds standards of FAA.

9.7 Unusual Events: Contractor is required to notify the Contracting Officer or his/her designee of any unusual events, including but not limited to accidents or safety problems that occur involving any VA beneficiary being transported under this agreement. This notification will be made within one (1) hour by telephone and, if requested by the VA, a written report of the event will be delivered to the Contracting Officer or his/her designee by close of business the next working day.

9.8 Aircraft Equipment: All aircraft shall comply with the regulations of the FAA, Federal

Aeronautics Regulations (Parts 135/121) and rules and regulations of the state in which Contractor conducts business. Furthermore, all aircraft used in the performance of this agreement must be equipped with functioning two-way radios.

Such aircraft must be equipped with all flight instruments required by the FAA regulations for the type of flight operations to be conducted. Such aircraft must also have the facilities to maintain proper cabin temperatures under all flight conditions.

9.9 Aircraft Information: The Contract shall also include the following information related to the aircraft:

Type of Aircraft Adequate Seat Capacity Certificates of Insurance

9.10 Maximum Payloads: Will be in accordance with the FAA standard applicable to the respective aircraft.

9.11 Deviations from FAA Regulations: All work related to this contract shall be performed by the Contractor in accordance with any applicable FAA, U.S.

Department of Transportation, or OSHA regulations, as well as applicable State health and safety regulations, health care accreditation standards (JCAHO or equivalent accreditation organization) and standard industry practices as defined by the Association of Air Medical Services for air ambulance transportation. Deviations from Federal Aviation Administration Regulations shall be reported in accordance with Federal Aviation Administration Regulations Part 91.3 and 135.19. Deviation decisions related to flight safety can only be made by the pilot who must consider the safety of all persons aboard as well as the needs of the patient.

9.12 This solicitation applies to non-scheduled operations of air transportation conducted under:

14 CFR Part 121 (“Supplemental Operations”) http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFra meSet

14 CFR Part 135 (“Commuter and On-Demand Operations”) http://rgl.faa.gov/RegulatoryandGuidanceLibrary/rgFAR.nsf/MainFrame?OpenFra meSet

9.13 FARs Part 135 Operators must be in compliance with applicable regulations as outlined in Federal Aviation Regulations Part 135: Operating Requirements:

Commuter & On-Demand Operations & Rules Governing Persons on Board Such Aircraft.

9.14 FARs Part 121 Operators must be in compliance with applicable regulations as outlined in Federal Aviation Regulations Part 121: Operating Requirements:

Domestic, Flag, and Supplemental Operations.

9.15 Medical Standards – refer to Federal Aviation Regulations (FARs) Part 61.23, Subpart A: “Medical Certificates: Requirement and Duration” Medical Class (1st, 2nd, or 3rd) Medical Date (FAA certified physician check)

9.16 Insurance: The Contractor shall obtain all necessary licenses and/or permits, equipment and supplies required to perform this service. The Contractor shall take all reasonable precautions necessary to protect persons and property from injury, damage, and danger during the performance of this contract. He/she shall be responsible for any injury to himself/herself, his/her employees as well as for any damage and/or loss of federal, personal, or public property that occurs during the performance of this contract that is caused by his/her employee's fault or negligence and shall maintain personal liability and property damage.

9.17 Inspections: The Government has the right to inspect the contractor premises, maintenance records of medical equipment and aircraft(s), flight logs, and dispatch records being used for the contracted services. Furthermore, annually the contractor must provide proof of insurance (see paragraph 10.9 and Clauses 852.228-71, and 852.237-70 for further details on insurance requirements) and copies of any licenses for all staff providing services under this contract upon request of the COR.

10. Infection Control Requirements

10.1 Health tests. Contractor attests that assigned personnel have fulfilled all testing and screening requirements as described below prior to first duty shift. Evaluations and tests shall be current within the past year, except as noted. At the VA’s request, Contractor shall provide proof that all requirements are current and fully met as described within 2 business days of request.

10.2 Tuberculosis Screening and Testing.

10.2.1 For those with previous documented positive Purified Protein Derivative (PPD) test results: All Contractor personnel shall provide a note from their physician, dated within the past three months stating they are free of any signs and symptoms of tuberculosis. This evaluation will be renewed annually.

10.2.2 For those with previously negative PPD skin test results: All Contractor personnel shall provide proof of a negative reaction to PPD testing, performed in accordance with the latest CDC standards and CDHC/California Tuberculosis Controllers Association guidelines, within the past 6 months. This test shall be renewed annually.

10.2.3 For PPD skin converters (a change from a previously negative skin test to positive; defined as an increase in duration of 10mm or more with 2 years): An evaluation from their physician within 30 days of the positive test stating they are free from signs/symptoms of TB and indicating whether prophylactic treatment is indicated. If treatment is indicated, a note from the physician stating it was satisfactorily completed.

10.2.4 Rubella Testing. All Contractor personnel shall provide proof of immunization for measles, mumps, rubella, or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with a follow-up documentation provided to the COR.

10.2.5 Varicella (Chicken Pox) Testing. Provide a history of varicella or, if unknown, results.

11 Applicable Directives:

11.1 14 CFR Part 119: Title 14 of the Code of Federal Regulations Part 119, issued by the FAA.

11.2 14 CFR Part 121: Title 14 of the Code of Federal Regulations Part 121, issued by the FAA.

11.3 14 CFR Part 135: Title 14 of the Code of Federal Regulations Part 135, issued by the FAA.

12 Quality Control (QC)

12.1 The contractor shall develop, submit for contracting office…