36C26023Q0247 0002.docx
DOCX document 30 KB Posted
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- V226--Wheelchair Transportation Services - 692
- Solicitation number
- 36C26023Q0247
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| File | Type | Posted |
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| 36C26023Q0247 0001.docx | DOCX document | |
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| Past Performance Questionaire.docx | DOCX document |
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5. PROJECT NUMBER (if applicable)
CODE
7.
ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER
3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF
PAGES
10A. MODIFICATION OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO.
1. CONTRACT ID CODE
FACILITY CODE
CODE
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE
OF YOUR
ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office.
is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.
15C. DATE SIGNED
B. THE ABOVE NUMBERE
D CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES
SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
RESULT IN REJECTION OF YOUR
OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendmen t, and is received prior to the opening hour and date specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED
STATES OF AMERICA
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER
16A. NAME AND TITLE OF
CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 30
PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF
SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign) (Signature of Contracting Officer) None 36C260 Network Contracting Office 20
ATTN: V4CONT
1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661 36C260 Network Contracting Office 20
ATTN: V4CONT
1601 E. Fourth Plain Blvd Bldg.17, Suite B428 Vancouver WA 98661 To all Offerors/Bidders
36C26023Q0247 02-24-2023
X X X New Quote Due Date: 03/02/2023 16:00 PT X One (01) The purpose of Amendment 002 is to make updates to the Price Schedule formula.
Please see Continuation Pages for revised Price Schedule when submitting quotes.
All Quoters shall utilize this new Price Schedule when submitting quotes.
New Quote Due Date: 03/02/2023 16:00 Pacific Time.
VA Contracting POC is Andrew O'Neal at Andrew.O'Neal@va.gov
Ross Byrne Contracting Officer
B.2 PRICE/COST SCHEDULE
Ordering Period One 5/1/2023 – 4/30/2024
| CLIN |
| Description Of Services – Services Non-personal |
| Estimated QTY |
| UNIT |
| UNIT PRICE |
| TOTAL COST |
| 0001 |
| Stretcher/Gurney transport trips within the 50 mile threshold. |
| 75 |
| TRIP |
| $ |
| $ |
| 0002 |
| Stretcher/Gurney mileage per mile outside the 50 mile threshold (51+) |
| 3,750 |
| MILE |
| $ |
| $ |
| 0003 |
| Wheelchair transport trips within the 50 mile threshold. |
| 600 |
| TRIP |
| $ |
| $ |
| 0004 |
| Wheelchair mileage per mile outside the 50 mile threshold (51+) |
| 8,000 |
| MILE |
| $ |
| $ |
| 0005 |
| Additional Contractor transport aide when authorized by VA Program Office for wheelchair or stretcher/gurney transport services. |
| 100 |
| EA |
| $ |
| $ |
| 0006 |
| Oxygen, E-Cylinder with minimum two (2) hour run time |
| 10 |
| EA |
| $ |
| $ |
| 0007 |
| Wait Time for Wheelchair or Stretcher/Gurney transport (15 Minute increments each) |
| 50 |
| EA |
| $ |
| $ |
TOTAL
Ordering Period Two 5/1/2024 – 4/30/2025
| CLIN |
| Description Of Services – Services Non-personal |
| Estimated QTY |
| UNIT |
| UNIT PRICE |
| TOTAL COST |
| 0001 |
| Stretcher/Gurney transport trips within the 50 mile threshold. |
| 75 |
| TRIP |
| $ |
| $ |
| 0002 |
| Stretcher/Gurney mileage per mile outside the 50 mile threshold (51+) |
| 3,750 |
| MILE |
| $ |
| $ |
| 0003 |
| Wheelchair transport trips within the 50 mile threshold. |
| 600 |
| TRIP |
| $ |
| $ |
| 0004 |
| Wheelchair mileage per mile outside the 50 mile threshold (51+) |
| 8,000 |
| MILE |
| $ |
| $ |
| 0005 |
| Additional Contractor transport aide when authorized by VA Program Office for wheelchair or stretcher/gurney transport services. |
| 100 |
| EA |
| $ |
| $ |
| 0006 |
| Oxygen, E-Cylinder with minimum two (2) hour run time |
| 10 |
| EA |
| $ |
| $ |
| 0007 |
| Wait Time for Wheelchair or Stretcher/Gurney transport (15 Minute increments each) |
| 50 |
| EA |
| $ |
| $ |
Ordering Period Three 5/1/2025 – 4/30/2026
| CLIN |
| Description Of Services – Services Non-personal |
| Estimated QTY |
| UNIT |
| UNIT PRICE |
| TOTAL COST |
| 0001 |
| Stretcher/Gurney transport trips within the 50 mile threshold. |
| 75 |
| TRIP |
| $ |
| $ |
| 0002 |
| Stretcher/Gurney mileage per mile outside the 50 mile threshold (51+) |
| 3,750 |
| MILE |
| $ |
| $ |
| 0003 |
| Wheelchair transport trips within the 50 mile threshold. |
| 600 |
| TRIP |
| $ |
| $ |
| 0004 |
| Wheelchair mileage per mile outside the 50 mile threshold (51+) |
| 8,000 |
| MILE |
| $ |
| $ |
| 0005 |
| Additional Contractor transport aide when authorized by VA Program Office for wheelchair or stretcher/gurney transport services. |
| 100 |
| EA |
| $ |
| $ |
| 0006 |
| Oxygen, E-Cylinder with minimum two (2) hour run time |
| 10 |
| EA |
| $ |
| $ |
| 0007 |
| Wait Time for Wheelchair or Stretcher/Gurney transport (15 Minute increments each) |
| 50 |
| EA |
| $ |
| $ |
Ordering Period Four 5/1/2026 – 4/30/2027
| CLIN |
| Description Of Services – Services Non-personal |
| Estimated QTY |
| UNIT |
| UNIT PRICE |
| TOTAL COST |
| 0001 |
| Stretcher/Gurney transport trips within the 50 mile threshold. |
| 75 |
| TRIP |
| $ |
| $ |
| 0002 |
| Stretcher/Gurney mileage per mile outside the 50 mile threshold (51+) |
| 3,750 |
| MILE |
| $ |
| $ |
| 0003 |
| Wheelchair transport trips within the 50 mile threshold. |
| 600 |
| TRIP |
| $ |
| $ |
| 0004 |
| Wheelchair mileage per mile outside the 50 mile threshold (51+) |
| 8,000 |
| MILE |
| $ |
| $ |
| 0005 |
| Additional Contractor transport aide when authorized by VA Program Office for wheelchair or stretcher/gurney transport services. |
| 100 |
| EA |
| $ |
| $ |
| 0006 |
| Oxygen, E-Cylinder with minimum two (2) hour run time |
| 10 |
| EA |
| $ |
| $ |
| 0007 |
| Wait Time for Wheelchair or Stretcher/Gurney transport (15 Minute increments each) |
| 50 |
| EA |
| $ |
| $ |
Ordering Period Five 5/1/2027 – 4/30/2028
| CLIN |
| Description Of Services – Services Non-personal |
| Estimated QTY |
| UNIT |
| UNIT PRICE |
| TOTAL COST |
| 0001 |
| Stretcher/Gurney transport trips within the 50 mile threshold. |
| 75 |
| TRIP |
| $ |
| $ |
| 0002 |
| Stretcher/Gurney mileage per mile outside the 50 mile threshold (51+) |
| 3,750 |
| MILE |
| $ |
| $ |
| 0003 |
| Wheelchair transport trips within the 50 mile threshold. |
| 600 |
| TRIP |
| $ |
| $ |
| 0004 |
| Wheelchair mileage per mile outside the 50 mile threshold (51+) |
| 8,000 |
| MILE |
| $ |
| $ |
| 0005 |
| Additional Contractor transport aide when authorized by VA Program Office for wheelchair or stretcher/gurney transport services. |
| 100 |
| EA |
| $ |
| $ |
| 0006 |
| Oxygen, E-Cylinder with minimum two (2) hour run time |
| 10 |
| EA |
| $ |
| $ |
| 0007 |
| Wait Time for Wheelchair or Stretcher/Gurney transport (15 Minute increments each) |
| 50 |
| EA |
| $ |
| $ |
Ordering Period One Total
Ordering Period Two Total
Ordering Period Three Total
Ordering Period Four Total
Ordering Period Five Total
GRAND TOTAL
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