36C26018Q0075-00001001.docx

36C26018Q0075

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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

12-05-2017 Enshane H. Nomoto 360-852-9857 12-13-2017

12PM PST

Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

X

621910 $15 Million Net 30 X

N/A

Department of Veterans Affairs Puget Sound Healthcare System

1660 South Columbian Way Seattle WA 98108 Y Department of Veterans Affairs Network Contracting Office 20

5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page The Department of Veterans Affairs seeks to award a firm-fixed priced Blanket Purchase Agreement (BPA) for Ambulance Services supporting the Puget Sound VAHCS and surrounding Community Based Outpatient Clinics (CBOCs) in accordance with the PWS.

b. Period of Performance Base Period: 1 January 2018 - 30 June 2020

c. VA Contracting POC: Enshane Nomoto, (360)852-9857 or enshane.hill-nomoto@va.gov.

d. Vendor Checklist for submittals is located prior to the Performance Work Statement (PWS).

See CONTINUATION Page

BETHANY D. IRETON

Contracting Officer

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

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

a. CONTRACTOR:

b. GOVERNMENT:

Contracting Officer 36C260 Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

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

3. INVOICES: Invoices shall be submitted in arrears:

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

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

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

Items to be included Initialed

1. Standard Form 1449, Complete Blocks: 17a, 30a – 30c 1)___________

1. Signed Amendment(s) SF30 (Completed and Signed if applicable) 2)___________ Amendment #

1. Contractor Data Submission Per FAR Clause 52.212-2 (Section E)

a) Recent Relevant Experience 3a)__________

b) Past Performance 3b)

c) Capability to Perform Service 3c) _________

1. Pricing/Cost/Schedule Completed (Section B) 4)__________

1. Contractor Certification and Representations Per FAR Clause 52.212-3 5)__________ (Section E) and https://www.sam.gov/

1. Past Performance Terminations (if applicable) 6)__________

ELECTRONIC SUBMISSIONS – Acceptable in PDF format or Scanned as well as Hard Copy.

If submitting via Hard Copy, Contractors shall submit their proposal to the address shown below by the date and time indicated in Block 8 of the SF 1449.

ALL OR NONE: Bids for less than specified quantities of each item in the Schedule will not be considered, and failure to submit a price for each item where required in the Schedule will be considered as a material deviation from the requirements of the solicitation, and the bid will be rejected.

B.2 PERFORMANCE WORK STATEMENT

Ambulance Contract for VA Puget Sound Health Care System

1. Contracting Officer’s Representative (COR)

Section:

Address:

Phone Number:

Fax Number:

E-Mail Address:

GENERAL

1. The VA Puget Sound Healthcare System (VAPSHCS) requires ground ambulance services to provide medical transport for its beneficiaries, as needed. Services shall be provided 24 hours per day, 7 days per week. The Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment and reports necessary for all ambulance services.

· Contractor shall be required to respond to emergent calls from American Lake (8 minutes response time) and non-emergent (30-minute response time) ground ambulance services;

· Contractor will be required to respond to requests to VAPSHCS and CBOC locations within 30 minutes for non-emergent; or as scheduled in advance by VA Travel staff.

· Ground ambulance services are needed for eligible beneficiaries of the VAPSHCS. Services must be available twenty-four (24) hours per day, seven (7) days per week, including all holidays.

2. The Contractor shall furnish all necessary personnel and equipment to provide ground ambulance services as requested to/from all locations:

1) Puget Sound HCS 1660 South Columbian Way, Seattle, WA 98108

2) American Lake, VAMC 9600 Veterans Drive, Tacoma, WA 98493

3) Bremerton CBOC 925 Adele Avenue, Bremerton, WA 98312

4) Mount Vernon CBOC 307 S. 13th St., Suite 200, Mount Vernon, WA 98274

5) North Olympic Peninsula 1114 Georgiana St Port Angeles, WA 98362

6) South Sound CBOC 151 NE Hampe Way, Chehalis, WA 98532

7) Valor CBOC Bellevue 13033 Bel-Red Road Suite 210, Bellevue, WA 98005

8) Valor CBOC North Seattle 12360 Lake City Way NE, Suite 200, Seattle, WA 98125

3. Upon the request of the VAPSHCS and based on the condition and needs of the patient, the Contractor will provide Basic Life Support (BLS), Advanced Life Support (ALS) and Critical Care Transport (CCT) ambulance transports of patients to designated locations. The Contractor may be required to transport patients to another facility for treatment or tests, wait while patient is receiving said treatment or test, and transport that same patient to a pre-determined destination.

4. Certification of Minimum Liability Insurance Coverage: A Certificate of Insurance, as evidence of insurance coverage, is required prior to providing any services to the medical facilities (ref. VAAR 852.237-7). Contractor shall provide the required proof of insurance to the COR within ten (10) calendar days after award and prior to providing any services. Thereafter, all changes shall be submitted within seven (7) calendar days after changes occur.

5. Infection Control Procedures: When ambulance services are required, the contractor shall universal precautionary measures for the prevention and control of the spread of infectious agents to all persons. The VA Infection Control Manual can be accessed at:

http://vaww/Departments/hospitalwide/Infection%20Control/index.asp

6. Contractor's Responsibilities and Insurance Requirements: The Contractor shall obtain all necessary licenses and/or permits required to perform this work. Contractor shall take all precautions necessary to protect persons and property from injury or damage during the performance of this contract. Contractor shall be responsible for any injury to himself, employees, or others, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his or his employees' fault or negligence. and in accordance with VAAR 852.237-7, Section I. Evidence of coverage is required before commencing work under this contract (copy of Certificate of Insurance), and it may not be changed or cancelled without thirty (30) calendar days prior written notice to the Contracting Officer.

DEFINITIONS

1. AMBULANCE – Vehicles for emergency medical care which provide a driver compartment and a patient compartment that will accommodate an Emergency Medical Technician (EMT), Paramedic (or RN as needed) and two litter patients, so positioned that at least one patient can be given intensive line support during transport; equipment and supplies for emergency care at the scene as well as during transport, and two-way radio communication and equipment for light rescue procedures.

The ambulance is designed and constructed to afford safety and comfort and to avoid aggravation of patient’s condition.

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

3. BLS – Basic Life Support (as define in Section VEHICLES).

4. BLS/With Lift for Power Wheelchair – Basic Life Support with wheelchair lift and lock downs to transport power wheel chair and stretcher patient (as define in Section VEHICLES).

5. ALS – Advance Life Support (as define in Section VEHICLES).

6. CCT – Critical Care Transport (as define in Section VEHICLES).

7. CO – Contracting Officer. The person executing this contract on behalf of the Government and is the only person authorized to make changes to the contract affecting scope, schedule and price.

8. COR – Contracting Officer's Representative (COR): VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. COR responsibilities will include, but not be limited to: surveillance of services required under this contract; determining the adequacy of contractor performance according to the specifications of this contract; acting as the Government’s representative; ensuring compliance with contract requirements insofar as the work is concerned, certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, serving as a number on the vehicle inspection team.

The COR cannot authorize deviations from the specifications and requirements of this contract. In the event the Contractor deviates without approval from the CO, such deviation shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor. The COR will be designated in writing by the CO after contract award.

9. CONTRACTOR: The term “Contractor” as used herein refers to both the prime Contractor and his employees, and with any subcontractors and their employees. The Contractor shall be responsible for assuring that his subcontractors comply with the provisions of this contract.

10. HEAR SYSTEM – Hospital Emergency Administrative Radio (HEAR) is a mobile communication system that allows units to provide patient information to base stations.

11. NORMAL BUSINESS HOURS – Normal business hours are defined as Monday through Friday, 8:00 a.m.

to 4:30 p.m. local time, except Federal Holidays.

New Year’s Day January 1st*

Martin Luther King’s Birthday Third Monday in January

Presidents’ Day Third Monday in February

Memorial Day Last Monday in May

Independence Day July 4th*

Labor Day First Monday in September

Columbus Day Second Monday in October

Veterans’ Day November 11th

Thanksgiving Day Fourth Thursday in November

Christmas Day December 25th*

*If the date falls on a Saturday, the Government holiday is the preceding Friday.

If the date falls on a Sunday, the Government holiday is the following Monday.

In addition to the days designated as holidays, the Government observes the following days:

Any other day designated by Federal Statute Any other day designated by Executive Order Any other day designated by the President’s Proclamation

12. MSA – Medical Support Assistant

13. NOD – Nursing Officer of the Day

14. MET TEAM (Medical Emergency Team)

15. TRIP / MILEAGE – A trip is defined as the distance, “ONE WAY ONLY,” over which a beneficiary will be transported. For all one-way trips ordered under this contract, the Contractor shall receive the base rate quoted under the “BASE RATE.” The “BASE RATE” shall constitute full compensation for ONE-WAY trips, which do not exceed the mileage threshold defined herein. The Contractor shall also receive the mileage charge quoted under the “MILEAGE RATE” for any one-way trip in excess of the mileage threshold. The “MILEAGE RATE” is applicable only for mileage in excess for the mileage threshold and in no event shall the Contractor receive reimbursement for mileage charges for any mileage less than the mileage threshold. In the event of a dispute regarding the mileage of a trip, www.bing.com/maps shall be the website utilized to resolve the disagreement using the shortest route reasonably available.

17. BARIATRIC GUERNEY - refers to any person whose weight or physical dimensions exceed the capability of a standard gurney in use by the ambulance service.

18. Staging Area at American Lake VAMC - The VAPSHCS will provide an Ambulance parking space and a room at VAPSHCS (American Lake Division) as a staging area for the contractor’s ambulance crew and vehicle. When the ambulance crew is dispatched from the staging area, the contractor will replace that crew and vehicle immediately.

VEHICLES

1. The demand for the ambulance is estimated to require a minimum of one (1), but not more than five (5) such vehicles at any one time. The Contractor shall make available not less than one (1) CCT vehicle in each of the greater King and Pierce County areas at any time in performance of this contract. In principle, the Specialty Ambulance shall act as an extension of the VAPSHCS Intensive or Coronary (Critical Nursing) Units, and care provided for patients in transport will include, but not be limited to:

· Basic Life Support and Advanced Cardiac Life Support, both as defined by the American Heart Association (AMA).

· Management of the airway and maintenance of effective respiratory exchange, to include placement of oral airways and endotracheal intubations.

· Monitoring of vital, neurological and electrocardiographic signs, including intake and output.

· Administration of intravenous (IV) fluids, including the management of existing lines and the placement of peripheral or central venous lines.

· Administration of oral, intramuscular or IV medications.

· Other appropriate nursing care for psychological and social requirements, wound care and dressing, nutrition and oral pharyngeal-tracheal-gastric suctioning, etc.

Execution of physician’s standing orders.

· Items provided per a physician’s orders.

· Cost of medications is excluded from prices quoted under the schedule. Only those specific medications prescribed by the appropriate personnel of the VAPSHCS and/or the Contractor’s staff physician shall be administered to a patient during transportation.

2. The above specified number is based on an estimate of an average minimum needed for trips to various locations at any one time, and is not to be construed as either a commitment to order such number or is limiting the number of vehicles which may actually be required.

3. The ambulances used under the terms of this contract will be licensed and meet the minimum vehicle requirements as mandated by Federal specification KKK-A-1822E and Washington State Department of Transportation. Minimum requirements are:

Basic Life Support (BLS) Ambulance

· Staffed by two Washington State Certified Emergency Medical Technicians (EMTs);

· EMTs certified to use cardiac defibrillators, perform emergency pharyngeal-tracheal lumen Intubations;

· All ambulances are equipped and licensed in Department of Health BLS requirements;

· Emergency care and transportation of the sick and injured, non-life-threatened patient;

· Performance of extrication and stabilization, administration of oxygen therapy;

· Monitoring of previously established non-medicated IV lines (i.e. lactate hangers, D5W, saline, etc.);

· Transport of medical IV only if on locked out pump, CAD or PCA pump, NOT POTASSIUM CHLORIDE.

Basic Life Support (BLS) Ambulance with Power Wheel Chair Lift and Lockdowns

· Staffed by two Washington State Certified Emergency Medical Technicians (EMTs) certified to use cardiac defibrillators, perform emergency pharyngeal-tracheal lumen intubations;

· Equipped and licensed in accordance with the Department of Health BLS requirements;

· Emergency care and transportation of the sick and injured, non-life-threatened patient;

· Performance of extrication and stabilization, administration of oxygen therapy;

· Monitoring of previously established non-medicated IV lines (i.e. lactate ringers, D5W, saline, etc.);

· Transport of medical IV only if on locked out pump, CAD or PCA pump, NOT POTASSIUM CHLORIDE;

· Wheel chair lift and lockdowns.

Advanced Life Support (ALS) Ambulance

· Staffed by Washington State Certified Paramedic and EMT;

· Paramedics certified in Advanced Cardiac Life Support (ACLS);

· Certified to perform medical treatment as authorized by respective county protocol for pre-hospital ALS service;

· All ambulances are equipped and licensed in accordance with the Department of Health BLS requirements.

Critical Care Transport (CCT) Ambulance

· Staffed by licensed Washington State Registered Nurse or Washington State Certified Paramedic and EMT

· Nurses have current Emergency Department and/or Critical Care Unit experience

· Nurses and Paramedics certified in CCT

· Inverters allow transport of complex hospital monitoring and/or life support equipment

· All ambulances are equipped and licensed in accordance with the Department of Health BLS Requirements

REPORTING REQUIREMENTS

1. All patients being transported to and from a VAPSHCS facility are to be considered emergent cases until determined otherwise by the appropriate VAPSHCS staff of the Emergency Room or Critical Care Unit of the receiving facility.

2. The HEAR Systems (Hospital Emergency Administrative Radio) will be used, at all times, to alert appropriate staff of the receiving activity and provide initial information as to the patient’s name, the presenting problem, present status and the expected time of arrival.

3. A written report will be submitted by the ambulance personnel to the VA personnel immediately upon arrival at the VAPSHCS facility. The written report will provide the following information to the maximum extent available:

· Patient’s full name

· Time picked up

· Where picked up

· Who called (initiator)

· Presenting problem

· Immediate first aid measures (bandages, oxygen, restraints, etc.)

· State of consciousness

· Blood pressure

· Pulse

· Respiration

· Any other noted symptoms or pertinent information, including a list of any medications taken

4. If the patient was initially treated by a Fire Department Aid Car, their report will be submitted together with the above required report. If there has been no change during transport, the EMT’s report will be submitted noting such information.

5. A similar written report will be required upon any prearranged transportation of critically ill patients who are to go directly to “inpatient admitting.”

INSPECTIONS

The Contractor is required to perform regular compliance and quality inspections of the vehicles and equipment. Upon request, a copy of the results will be provided to the COR.

NUMBER OF PATIENTS

Only one patient will be transported on a trip unless specifically authorized and requested by the VAPSHCS. No more than one psychiatric patient may be transported at any time, unless prior authorization is received from the designated COR. When more than one patient is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient. Contractor must ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

The authorized official who is requesting ambulance services may, in the best interest of the patient, pre-authorize a relative, VA Registered Nurse, or physician to accompany the patient.

STAIRS

There will be no extra charge for removing or loading patients from trains, airplanes, and/or other structures where it is necessary to use a flight of stairs.

WAITING TIME

1. Waiting time will not apply to reasonable time required for loading and unloading. For time lost at either or both ends due to causes beyond his/her control, the contractor will be reimbursed one-fourth the hourly rate shown in Pricing Schedule, for each quarter hour, or fraction thereof the first 30 minutes from the time he/she reports arrival. As soon as a delay is anticipated, the contractor will contact the transportation office during normal working hours. During irregular duty hours the contractor will contact the Administrative Officer of the Day (AOD is located at the Seattle Division).

2. For time loss while traveling by the Washington State Ferry System, the Contractor shall be reimbursed ONE WAY ONLY for ferry costs and waiting time at the rate of one-fourth the hourly rate proposed in the contract cost for each one fourth hour for embarkation, debarkation and ferry transport time. Ferry trip time will be determined by the most current Washington State Ferry System’s published schedule.

RATE

Payment for mileage traveled will be limited to “one way only”, the distance over which the patient is transported. Total cost per trip shall be determined by the actual distance of the authorized trip from the specified point of origin to the specified final destination, including applicable waiting time.

ORDERS

1. Authorized VAPSHCS personnel will place telephone requests (orders) for Prescheduled and Emergent Contract Services only with the Contractor’s Dispatch office. The request for services shall specify the originating point and final destination. Only such travel is authorized and any costs incurred for unauthorized travel, stops, waiting time, etc., will be the responsibility of the Contractor. The contractor is cautioned that performance of a trip or substitution of type of vehicle at the request of others, without approval of appropriate authorized personnel, may be deemed as unauthorized travel for which the Contractor may bear the risk of non-reimbursement. Authorized VAPSHCS personnel are:

· COR

· Travel Clerks (Seattle and American Lake)

· Beneficiary Travel Supervisors at American Lake and Seattle VAMC

· Urgent Care Staff at VAPSHCS American Lake Division

· ER staff at VAPSHCS Seattle Division

· Administrative Officer of the Day (Seattle)

· Irregular Tour MSA (American Lake)

· NOD (nursing officer of the day)

· MET TEAM MEMBERS

· VA Telephone Operators

2. Request for Services:

When ordering services (whether it be by telephone, facsimile, mail, e-mail and/or in person), the VA Medical facility will provide the Contractor with the following information:

Prescheduled

· Mode of transportation required: BLS, ALS, CCT

· Required date and time of arrival

· Name of beneficiary

· Pick-up and delivery point (include Bldg/room/ward number; clinic name, etc.)

· Description of the emergency

1) Condition of patient

· Type of equipment required

· Emergent Contract Services

· Patient’s name

· Condition of patient

· Are lights and sirens requested?

· Description of the emergency

· Location of the patient

· Caller’s name and call back number

Emergent transport requests from Puget South Health Care System require the contractor to arrive at the point of patient pickup within 8 minutes after receipt of the call. If the Contractor cannot meet the response time, the Contractor will immediately dispatch a third party vendor. There will be no mark-up or premium applied to the contract rate on for dispatch of a third party vendor.

4. For prescheduled pickups, the Contractor will be required to furnish the ambulance service within ten (10) minutes of the prearranged time.

5. For non-emergent calls, the Contractor will be required to arrive at the point of patient pickup within 30 minutes after the receipt of call. If the contractor fails to furnish the services within the time specified, a penalty of twice the wait-time rate, to be computed in quarter hour increments will be assessed and paid to the Government. If the Contractor identifies they cannot furnish the services within the time specified, the Government reserves the right to obtain the necessary services from another source and charge the Contractor for any excess costs which may result there from. The Government will be sole judge in determining when to order services from a different source; however, in no instance will the Contractor be required to furnish more than the number of ambulances and/or specialty ambulances he/she has agreed to furnish in the performance of this contract in accordance with other provisions set forth herein.

6. If a BLS or ALS unit is requested and dispatched and after arrival at the pick-up point the crew feels a CCT unit is needed; the contractor will provide a CCT unit within 8 minutes and notify VAPSHCS of the need for the CCT Unit.

7. If a BLS, ALS, or CCT unit is needed with a bariatric gurney, the contractor must respond within 60 minutes for a non-emergent transport.

8. If the Contractor cannot meet the response time, the Contractor will immediately dispatch a third party vendor. There will be no mark-up or premium applied to the contract rate on for dispatch of a third party vendor,

9. In the event of a “NO SHOW” or any other cause without fault or negligence on the part of the Contractor, which results in no patient being transported, equitable reimbursement will be made as follows:

· Minimum payment of Base Fee (response and dispatch of vehicle)

· As applicable, mileage outside city limits and toll charges including waiting time “one way only.

10. The VAPSHCS will provide an ambulance parking space and a room at VAPSHCS (American Lake Division). This will serve as a staging area for the Contractor’s Ambulance crew and vehicle. If the ambulance and crew is dispatched from the staging area by American Lake staff, the Contractor will immediately replace with another ambulance and crew to ensure onsite coverage for emergent ambulance needs.

11. The VAPSHCS staff will determine the pick-up and destination of the patient based on the patient’s current condition. Stable patients may be transported between the American Lake and Seattle division, or to a community facility; or any other destination. Unstable patients will be transported to the nearest ER unless otherwise instructed by VA clinical staff. If a patient’s condition changes during transport the Contractor will take the appropriate action and notify VAPSHCS of the change in the patient’s condition and any change in destination

MEDICATION

Any costs of medication furnished to the patient during transport are excluded from the prices quoted in the price list. Only those specific medications prescribed by the appropriate medical staff of the VAPSHCS and/or the Contractor’s staff physician will be authorized and are to be invoiced as a separate item(s). Medication shall conform to the requirements of the most current County Advanced Life Support Approved Drug List.

TOLL CHARGES

It is agreed and understood that the prices quoted in the schedule do not include any ferry, bridge, tunnel or road toll charges. Any such legitimate toll charges incurred shall be limited to “one way only” and shall be listed separately on the Contractor’s invoice.

PERSONNEL

1. The Contractor shall ensure that the following requirements are met:

· Ensure and certify that personnel performing the services required under this contract are properly licensed and fully trained in the use of the vehicle and equipment that will be used in the performance of this contract.

· Ensure that the vehicle is operated with sufficient personnel for adequate patient care, at least one of who shall be an EMT.

· The Contractor shall maintain records of each employee as to character, training qualifications and physical capabilities of performing the duties of an ambulance driver and/or attendant.

· Records shall be made available to the VAPSHCS for inspection upon request.

2. EMTs shall have the responsibility for both the operation of the vehicle and for the care of patients before they are placed aboard the vehicle and during transit. The EMT shall be responsible for the care of the patient until such time as the patient is transferred to appropriate medical staff at destination. EMTs providing emergency services under this contract must have the following qualifications:

· Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 81 hours of “equivalent training” including an in-hospital training period. Such training program must also be acceptable under the regulating requirements for local EMS systems supported by DHHS under PL 93-154 (see 42 CFR Chapter IV Section 410 published in the Federal Register at Volume 64 Page 3658, dated 01-25-1999)

· Must be certified, licensed or otherwise officially recognized by the local, state, or regional Government or public entity where the emergency ambulance service is operated or by which it is governed.

· Must be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the local or state government entity in which the services is rendered to veterans, but in no instance shall this be less frequently than every two (2) years. Such “refresher” training must be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.

· Evidence of successful completion of all training must be submitted to the Department of Veterans Affairs upon request.

3. Non-emergency attendant/driver. Drivers providing service under the contract shall have a valid ambulance personnel license with a driver designation as required by Federal, State and local law. Contractor shall be responsible for assuring that its drivers are knowledgeable and competent in emergency vehicle operations and thoroughly familiar with the vehicles assigned. Contract prices include services of non-emergency medical attendant/driver. Attendant/driver must have techniques (CPR) of the American Red Cross, U.S. Bureau of Mines, or other equivalent; be able to safely use all associated equipment, such as wheelchair lifts and fire extinguishers; and been fully briefed and trained in passenger assistance techniques. Proof in the form of a current certificate that first aid training has been successfully completed must be available upon request.

4. Background Criminal Checks and Investigations. The VA requires that all contractor personnel performing services under this contract require background investigations. Individuals that hold a current background investigation report will not be required to undergo an additional investigation. However, the VA Office of Security and Law Enforcement must verify existence of the investigation report. Requests for background investigations must be submitted no later than 30 days after award of the contract.

NOTE. The offeror must screen all employees to ensure that they meet core competencies on an annual basis; that they have performed a criminal background check on any staff member who will be treating or transporting patients, etc. The Contracting Officer or designated COR may request Contractor records to determine if training is current and training standards are up-to-date.

PERFORMANCE STANDARDS

1. The Contractor is expected to meet all of the requirements of this contract at all times. If the services are not performed in a timely and professional manner, patient health and safety may be compromised. Due to the nature of this requirement the following performance standards are included.

2. The last month of each contract year the CO will review contract compliance reports submitted by the COR. Compliance must not fall to 95% or below, or a Contractor Discrepancy Report will be issued to ensure immediate corrective action and to avoid further action by the CO.

3. Amounts deducted from invoicing, due to performance issues and billing discrepancies, may be avoided if mitigating evidence is presented by the Contractor.

CONTRACTOR QUALITY CONTROL INSPECTION SYSTEM (QCIS)

The Contractor shall establish and maintain a complete Quality Control Plan (QCP) to assure the requirements of this contract are provided as specified. An original and one (1) copy of this QCP will be forwarded to the CO along with the requested initial proposal. The Contractor’s QCP shall include the following, showing proof of availability at the CO’s request during performance of contract, at a minimum:

· An inspection plan covering all services required by this contract. The inspection plan must specify the areas to be inspected on either a scheduled or unscheduled basis, how often inspections will be; accomplished and documented, or the title of the individual(s) who will perform the inspections;

· On-site records of all inspections conducted by the Contractor noting necessary corrective action taken. The Government reserves the right to request copies of any and/or each inspection;

· Incorporation of either active or established internal policy or procedures for updating medical service protocols that may affect performance of contract;

· The methods for identifying and preventing deficiencies in the quality of service performed, before the level of performance becomes unacceptable and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring total acceptable performance;

· On-site records of all vehicle maintenance and repairs performed, on vehicles used in the performance of this contract. The methods of identifying and preventing vehicle breakdowns, and detailed procedure for alternative transportation of Veterans in the event of mechanical breakdown of ambulance.

· On-site records identifying the character, physical capabilities, certifications and ongoing training of each employee performing services under this contract;

· The methods of identifying and preventing radio communication breakdowns. A detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle radios;

· A log to account for all requests for service. The log shall indicate the date and time of service call, name of the beneficiary requiring services, any required Medicare/Medicaid forms with Doctor’s signatures, type of transportation requested, designated pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points, if waiting charges are claimed;

· On-site records of any complaints or problems, with procedures taken to allow for corrective and/or elimination before effects caused interruption of performance of contract.

INVOICE PROCEDURES

1. Invoices shall be submitted no later than fifteen (15) calendar days following the end of the month of services and are to include all contract services furnished for the preceding month. Invoices shall specify the following per trip for which payment is requested:

Authorized VA Caller’s name requesting the transport, Patient name, Date of service, Pick-up and delivery point, Trip number, Itemized charges (i.e. toll fee, waiting time, medications, etc.)

The Contractor shall provide a Patient Care Report (PCR) for each individual patient transported.

2. Invoices will be reviewed and reconciled with trip tickets, Patient Care Reports (PCR) and travel logs. The vendor will provide a patient care report (PCR) for each patient that was transported. Unauthorized charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been pre-approved by authorized VA personnel. A final determination will be made within 30 days after notifying the Contractor of charges being suspended.

3. In accordance with VA accounting procedures and in order to provide an audit trail for questions and concerns pertaining to payments, the Contractor shall be furnished a Purchase Order number at the beginning of each option year. This number must be on the electronic invoice.

4. All invoicing rendered by the Contractor to the VAPSHCS for contract services furnished in accordance with this contract shall be in full. NEITHER THE BENEFICIARY NOR ANY OTHER PARTY SHALL BE REQUIRED TO BEAR THE BURDEN OF ADDITIONAL PAYMENTS, SURCHARGES, TIPS OR OTHER GRATUITY.

CONTRACT ADMINISTRATION

1. The Contracting Officer is responsible for the administration of this contract. The successful Contractor is advised that ONLY the Contracting Officer has authority to make changes affecting:

Contract prices and pricing issues Estimated quantities Delivery terms and conditions Term of the contract

2. In no event shall any understanding, agreement, modification or change order between the Contractor and a person other than the Contracting Officer be effective or binding upon the Government.

(END PERFORMANCE WORK STATEMENT)

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

PERCENTAGE

Price list showing rates (with % applied) will be attached to each call placed on the Agreement.

Contract Period: Base POP Begin: 01-01-2018 POP End: 06-30-2020

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B.4 INTRODUCTION

In the spirit of the Federal Acquisition Streamlining Act, the Department of Veterans Affairs (DVA) and hereby enter into a cooperative agreement, otherwise referred to as a Blanket Purchase Agreement (BPA), to further reduce the administrative costs of acquiring supplies/services.

The agreement details all services with accompanying prices and descriptions, which may be ordered under this BPA.

All orders placed against this BPA are subject to the terms and conditions of all the clauses and provisions in full text or incorporated by reference in this document.

B.5 TERMS AND CONDITIONS

The Contractor agrees to the following terms of a Blanket Purchase Agreement (BPA) EXCLUSIVELY WITH the Department of Veterans Affairs:

B.6 ADMINISTRATIVE DATA

A Blanket Purchase Agreement (BPA) is hereby established between and the Department of Veterans Affairs under the following terms and conditions incorporated in this BPA:

Primary Point of Contact:

Alternate Point of Contact:

DUNS NUMBER:

Cognizant Office (Include complete address):

Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

B.7 PRICING DATA

1. The prices included on the BPA list (or applicable "discounted" rates submitted in a proposal response to an RFQ resulting in award) that are in effect on the effective date of an order shall govern that order's basic performance period. With regard to any option years, which are later exercised, the proposed option year rates as incorporated into the order award are in effect until such time, if applicable, that the contractor has been authorized a rate increase culminating from a negotiation with the Contracting Officer.

2. The BPA holder can voluntarily reduce offered prices at any time by giving 24-hour advance notice (by facsimile or electronic-mail) to the Department of Veterans Affairs/Contracting Officer. This BPA also allows for additional discounts if a "large order" is placed at one time. An advanced notice is not required for discounts offered for only an individual order. Whether an order is large enough to warrant such a discount is subject to the discretion of the BPA holder.

3. The BPA holder may also increase BPA prices at any time. Any BPA price increase shall not take effect until the Department of Veterans Affairs Contracting Officer receives written notification (U.S. mail, facsimile, or electronic-mail). Any order already issued shall not be affected by any change to BPA pricing. The prices offered under this BPA will undergo annual review by the Department of Veterans Affairs Contracting Officer.

B.8 OPTION TO EXTEND THE TERM OF THE BPA

a. The Government may extend the term of this BPA by written notice to the Contractor at any time prior to the expiration of the BPA, provided that the Government shall give the Contractor a preliminary written notice of its intent to extend at least 10 days before the BPA expires. The preliminary notice does not commit the Government to an extension.

b. If the Government exercises this option, the extended BPA shall be considered to include this option provision.

B.9 SEGREGATION OF COSTS

a. The "Payments under Time-and-Materials and Labor-Hour Contracts" clause provides for reimbursement to the contractor of costs incurred for certain items and services purchased directly for the contract, subject to certain limitations set forth in the clause. Such items may include the lease/purchase of equipment, travel expenses for Government- directed travel, consumable materials, tuition and registration fees for specialized training, and other services or items acquired for the Government's account under the Government Property clause. The items and services which the BPA holder is authorized to purchase on a cost- reimbursement basis shall be limited to only those specific items and services described in the order(s) issued to the BPA holder as authorized for purchase.

b. The BPA holder shall segregate costs associated with materials and other items authorized to be purchased on a cost-reimbursement basis (to be specified in each order) from other costs associated with the performance of this contract in such a manner that at any time the costs subject to reimbursement under each order shall be readily ascertainable.

c. The "Ceiling Price" referred to in the "Payments under Time and Materials and Labor-Hour Contracts" clause shall be the ceiling price as stated in each order.

B.10 GENERAL SERVICES ORDERS

a. The BPA holder shall furnish all the necessary qualified personnel, materials, facilities and management resources to furnish the services set forth in the Statement of Objectives (SOO) or the Performance Work Statement (PWS) within the terms specified and at the price(s) stated.

b. It is understood and agreed that the BPA holder shall provide Fixed-Price proposals when requested by the Contracting Officer (CO). The contractor's proposal shall be priced using labor rates and labor categories here in provided. The CO will issue Fixed Priced Orders upon completion of negotiations of contractor proposals.

B.11 LABOR HOUR ORDERS

a. It is intended that the majority of orders issued for performance under this BPA will be Fixed-Priced Orders. However, on occasion Labor Hour Orders may be issued. This section applies to such orders only.

b. The BPA holder shall furnish all the necessary qualified personnel, materials, facilities and management resources to furnish the services set forth in the Statement of Objectives (SOO) or the Performance Work Statement (PWS) within the terms specified and at the price(s) stated. All orders will be issued and modified at the labor rates in effect at the time the work is performed.

c. It is understood and agreed that the BPA holder shall use in the performance of the contract the labor categories and hours specified in each order.

d. The labor categories and hours specified in each order represent the current best estimate of the services to be performed. To enhance flexibility and to allow the BPA holder to determine the optimum labor mix for the order the BPA holder may without notice to the Government, increase or decrease the number of hours for each category specified in the individual order by no more than %. These adjustments are allowable only to the extent that the ceiling price and the total number of hours of the labor CLIN(s) are not exceeded. The BPA holder will not be paid more than the ceiling price of any individual order.

e. Government Reimbursement of BPA Holder-Incurred Training Costs in Support of Mission-Unique Department of Veterans Affairs Requirements. BPA holder\personnel are required to possess all the skills necessary to support at least the minimum requirements of the Performance Work Statement (PWS) tasking for the labor category under which they are performing. Training to meet such minimum requirements must be provided by the BPA holder and is included in the fixed price labor rates. In situations where the "Government User" being supported by an order under the basic contract requires some "unique" level of support beyond the minimum requirements of the PWS because of program/mission-unique needs, then the BPA holder may directly charge the order (in the same manner as one might charge work-related TDY expenses) in order to obtain the unique training required for successful support if authorized in the order. Such education/training might be provided by Government entities or by "third party" private entities such as companies who specialize in providing professional or specialized training/education seminars/classes. Direct labor expenses, and travel related expenses allowable under the Joint Travel Regulations (JTR), may be allowed to be billed on a cost reimbursement basis. Tuition/Registration/Book fees (costs) that may be applicable to an individual course/seminar may be recoverable as a direct cost if specifically authorized in a particular order.