36C26120Q0500-008.docx

36C26120Q0500

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

36C26120Q0500 04-16-2020 Leah Solomon 916-923-4524 04-24-2020 11:00

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan

CA

95652-2609 X X 621511 $35 Million N/A X VA Northern California Healthcare System 5342 Dudley Blvd., Bldg. 209 McClellan

CA

95652

612MCP

Department of Veterans Affairs Department of Veterans Affairs VA Northern California HealthCare System 3230 Peacekeeper Way, Bldg. 209 McClellan

CA

95652-1012

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin

TX

78714-9971 See CONTINUATION Page See CONTINUATION Page X Stephanie San Juan

VA-VHA-RPOW-2019-252FE611

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

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-9(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:

Page 1 of Page 1 of Performance Work Statement for Dermatology Mohs Surgery Services

GENERAL:

· The contractor shall provide a cryostat for Mohs technician use for processing specimens.

· The Mohs Tech should arrive early enough to be ready to process specimens as soon as they are obtained.

· The Mohs Tech is responsible for maintaining the cryostat, setting up the work area, completing and maintaining the Mohs log, maintaining the appropriate paperwork for the tissue, marking and orienting the tissue correctly, embedding, cutting and staining the specimen so that usable sections can be analyzed by the Mohs surgeon, storing the tissue appropriately, observing and maintaining appropriate safety precautions, cleaning up the laboratory area after use, and Quality Assurance.

· The C&A requirements do not apply, and a Security Accreditation Package is not required. Mohs Tech will have no computer access at the SF VAMC.

PLACE OF PERFORMANCE:

Contractor shall furnish services at the VA Medical Center San Francisco 4150 Clement street, San Francisco, CA. 94121.

AUTHORITY:

Title 38 USC 8153, Health Care Resources (HCR) sharing Authority

POLICY/HANDBOOKS:

VHA Directive 1101.12 MOHS MICROGRAPHIC SURGERY

a. Resources Needed for Mohs Operative Suite, MMS SharePoint

b. Required Resources for Mohs Laboratory, MMS SharePoint

c. Required MMS Operative Documentation, MMS SharePoint

d. Mohs Lab Slide Quality Control, MMS SharePoint,

e. Quarterly Proficiency Quality Control Form Cover Sheet, MMS SharePoint

f. Daily Tissue Staining Quality Control Form, MMS SharePoint

g. Staff Support Needed for Mohs Micrographic Surgery, MMS SharePoint, MOHS MICROGRAPHIC SURGERY SITE ACTIVATION

General Information. General Information about the Mohs Micrographic Surgery Site Activation Plan, MMS SharePoint Checklist. Mohs Surgery Site Activation Checklist, MMS SharePoint

VHA MOHS SHAREPOINT:

https://dvagov.sharepoint.com/:f:/s/VACOVHAPS/10ppolrev/EjWufiO6mEJNk1jnEFXAcKYBUjubnTRyK_Ylcr_IHYIMTg?e=5U3SP3

VAMC SAN FRANCISCO DERMATOLOGY MOHS SURGERY POLICY AND PROCEDURE

TISSUE PROCESSING PROTOCOL FOR MOHS MICROGRAPHIC SURGERY

SCOPE:

Mohs surgery is performed using intraoperative frozen section slide evaluation to determine a clear margin for skin cancer, and these cases are routinely performed at the SFVA dermatology department. The frozen remnant of the final margin specimen is submitted to Pathology in 10% buffered formalin for permanent sections.

CRYOSTAT:

1. The cryostat temperature is at an optimum cutting temperature between -18*C to -35*C. Check and log the temperature using an external thermometer. If out of range, notify a supervisor and document corrective action in the temperature log.

1. Make sure the handle is in locked position.

1. De-ice microtome as needed using isopropanol.

1. Oil all moving parts.

1. Secure the blade holder tightly.

1. Place the brushes, heat sink and lastly the disposable blade into the cryostat chamber.

PERSONAL PROTECTIVE EQUIPMENT:

· Place gloves and a face mask with a shield near the work area so these are readily available while working with fresh tissue and for

SET UP:

1. Cover the work area with polyback drapes or any other non-porous covering to protect the counters.

1. Set up your tools in a safe and ergonomic manner.

1. Place your stains in the back of your work area. Make sure all reagent containers are marked with the appropriate reagent name.

1. Place your inks on one side and the cover slipping gear on the other.

1. Place the cutting board in the front closest to you and the scalpel just above the cutting board at 12 o’clock with the blade facing the cutting board.

1. Place chucks, embedding medium, slides, and a slide marking pen close to the cryostat.

1. Fill your cryac with liquid nitrogen following the LN2 Protocol using protective gear (as stated in the LN2 protocol below) and place it close to the cryostat on an even surface.

1. Make sure the room/lab temperature lies within the accepted range of 68-82 degrees of Fahrenheit. If out of range, notify a supervisor and document corrective action in the temperature log.

LN2 PROTOCOL:

1. Liquid nitrogen is extremely cold and can result in burn injuries if exposed to bare skin.

1. Make sure that you wear eye protection (face shield or safety glasses) and loose fitting insulated gloves whenever you are handling liquid nitrogen.

1. With the cryac on a flat surface, slowly pour the LN2 into the container and be careful not to overfill the cryac. There is a line in the inside of the cryac that is approximately 1 inch from the top. This is the fill line according to cryac manufacturer.

1. Screw the lid of the cryac on so that it is finger tight making sure that the red gasket is in place when doing so.

MOHS LOG:

1. Fill in all the information as it becomes available.

1. There are 5 sections each day that need to be completed: Patient Log, Cryostat Maintenance Log, Cryostat Temperature Log, Mohs Lab Room Temperature Log, and Stain Quality/Section Quality Control Log.

1. Review the Physician Profile and apply any special protocol noted on the profile to the workflow.

RECIVING THE SPECIMEN:

When picking up a specimen for frozen sectioning from the clinic, ask the surgeon for additional history that could be important in determining the diagnosis. It is useful to know the prior history of cancer, clinical differential diagnosis, or the question the frozen section seeks to answer (e.g., diagnostic tissue obtained, margins free of tumor etc). Ensure you have corresponding paperwork for any tissue. Make sure the orientation (12 o’clock) and the surgical marks correspond with the map whether it is drawn by the surgeons or the technician. Log all information needed in the Mohs log. Add accession number on the map if applicable.

MAPPING/RELAXING/INKING*:

Map out your work Use markings preferred by the surgeon Place the specimen on the prep board so that the 12’ orientation of the specimen matches the 12’ orientation of the prep board Divide the tissue into sections appropriate to fit on the slide There can only be one-site per slide Lay margins down using relaxing incisions Ink margins with permanent marking system and indicate appropriate colors on the map if not already performed by Mohs surgeon Number each piece of tissue

* The laboratory director will establish/document whether or not each Mohs technician is qualified to complete high complexity testing. If the Mohs technician is qualified, then testing will proceed as outlined in this protocol, if not, the Mohs surgeon will be responsible for grossing the tissue, i.e. drawing the map for the Mohs surgery case, indicating which inks are used, and inking the tissue. The surgeons would also be responsible for any other description of the tissue. Once this portion of the testing is complete, the Mohs technician can proceed to follow the protocol as outlined above.

EMBEDDING THE TISSUE:

1. Specimen is positioned on a slide about ¼ of an inch from the bottom.

1. Carefully place the slide on the bottom of the cryostat and leave it to freeze for 10-15 seconds.

1. Label chuck on the back side to ensure you know which chuck belongs to which patient for any re-cuts.

1. Place a chuck on the freeze bar and cover it with embedding medium.

1. Carefully pick up the slide and cover the tissue with embedding medium.

1. Invert the slide on top of the chuck and sandwich them together.

1. Spray it with liquid nitrogen or freezing spray pulsing the spray to give the cold a chance to penetrate to the depth of the tissue.

1. Let chuck freeze for a few minutes with the heatsink on it.

CUTTING:

1. Be sure the cryostat handwheel is in the ‘lock’ position at all times, except when actually cutting the frozen section. Minimize the use of the pressurized cryofreeze to limit aerosolization.

1. Place the chuck in the ball joint and tighten the thumbscrew securely.

1. Bevel the chuck to remove excess medium.

1. Angle the chuck parallel to the blade.

1. Turn the advancement wheel until the tissue is in contact with the blade.

1. If there are any questions, show the tissue to the attending before cutting the frozen section.

1. Face off the specimen until the skin edge and the depth are visualized.

1. Clean the blade of shavings and cut a section using constant and controlled speed.

1. Guide the specimen on top of the blade holder and pick up the specimen with a clean slide. If a treated slide is used make sure that the specimen is picked up on the right side of the slide.

1. Cut sections at 4-6 microns thick

1. Label each slide with patient’s name, accession number, level and piece numbers.

1. Make sure you have at least 6 cuts to present to the surgeon.

1. Prepare an extra slide for Quality Control and present it to the surgeon with your first case to ensure stain quality and make sure the review of the slide is documented on the Quality Control Log.

1. The blade is changed on each Mohs day (Mohs is performed 1-2 x weekly). This is done more often if requested by the surgeon depending on the number of sections cut weekly.

STAINING AND COVERSLIPPING:

The slide containing the freshly cut frozen section is placed into a slide cradle, and placed sequentially into the following solutions, with intermittent dipping to ensure even staining:

a. Hematoxylin and Eosin Staining Regimen:

Withdraw the slide from the last alcohol bath and drain from excess alcohol. Apply a line of Clearium on the slide. Place a coverslip over the slide. Wipe the back of the slide and any excess medium that might push out on the sides.

Place the slides on a flat and take them to the doctor with the corresponding map.

REPORTING OF FROZEN SECTION RESULTS:

The diagnosis is documented on the Mohs map with the initials of the Mohs surgeon. After reporting the diagnosis, and confirming that no further cuts are necessary, the frozen residual tissue should be placed into a labeled container filled with 10% buffered formalin and submitted to pathology department for accessioning and permanent sections. The residual frozen tissue must be submitted for paraffin-embedding and preparation of histologic sections using labeled cassettes with alphabetical sequence.

PERMANENT SLIDE LABELING:

1. After slide has been read by the surgeon, label each slide with a paper label on the frosted end making sure it doesn’t cover any tissue.

1. Each slide should have the following information: (Date, Last Name, First Name,

1. Site/Location, Stage and Specimen Section #, Accession #)

1. Make sure all of the slides are accounted for.

1. Place the slides in cardboard slide holders and put in a place designated by the

1. Mohs physician so that they can dry for 2 weeks (in Mohs lab Building 200, Module 3, room GA-178A). At that time the office can safely store in permanent storage (Building 203, room 1C-13).

FROZEN SECTION STAIN MAINTENANCE:

All the reagents will be appropriately labeled. The solutions for staining of frozen sections will be changed at least once a week, or more often if necessary. This change will be recorded on the Cryostat Maintenance Log.

CLEAN UP:

1. After the surgeon has cleared all patients you will start the cleanup process.

1. Always first dispose of any sharps. All sharps including the disposable cryostat blade, scalpel blades, and used slides are disposed of in the sharps container.

1. The cryostat is cleaned by first taking out the blade holder and rinsing it with water and then finally with 99% alcohol before storing it.

1. Next the microtome and surrounding chamber is brushed clean of all shavings and the shavings are disposed in a biohazard container.

1. Outside of the cryostat is wiped down with a disinfectant.

1. When cryostat is defrosted the microtome and chamber are wiped down with the same disinfectant.

1. Pour reagents and wastewater into chemical waste container. This waste container will be emptied by Environmental Health & Safety at least every 2 weeks or more frequently if needed.

1. Throw away counter liners and wipe down counters.

RETENTION OF GLASS SLIDES:

The glass slides will be stored under appropriate conditions with minimum retention times as follows. All the Mohs surgery slides (located in building 203, room 1C-13), records (entered into patient electronic medical record and Mohs case log) and blocks (stored with pathology department) will be stored and retained for 10 years from the date of exam.

FROZEN SECTIONS COMPETENCY ASSESSMENT:

· Initial certification and annual competency assessment for all Mohs technicians will be performed by Got Mohs? Travel Tech Mohs Services, Inc. and provided to SFVAHCS Dermatology Service

· Records will be stored in Mohs Binder and on our sharepoint

HOURS OF OPERATION/SCHEDULING:

Patient Access/Timeliness of Scheduling:

The Contractor will ensure contractor personnel are present based on pre-determined schedule from 8:00am until all cases finished and dismissed by Mohs Attending.

Cancellations:

Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

CONTRACTOR RESPONSIBILITIES

The contractor is responsible for performance of ALL terms and conditions of the contract.

CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards. The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

STANDARDS OF CARE:

The contractor personnel(s) care shall cover the range of Mohs Technician services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

Mohs Micrographic Surgery (MMS) guidelines by the American Osteopathic Association (AOA) Board of Dermatology (AOBD) http://www.osteopathic.org/inside-aoa/accreditation/postdoctoral-training-approval/postdoctoral-training-standards/Documents/Basic-Standards-MOHS.pdf The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

The requirements contained in this PWS

MEDICAL RECORDS:

Authorities: Contractor’s personnel(s)providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

HIPAA: Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: (No , only name, last 4, diagnosis as needed for labeling/handling of slides Direct Patient Care: Estimated 0 %

PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

Quality Management/Quality Assurance Surveillance: Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

Performance Standards: The contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM

As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed the Simplified Acquisition Threshold and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.

Each Contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold requires a CPARS evaluation. A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.

For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the Contractor’s designated representative for comment. The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

GOVERNMENT RESPONSIBILITIES

Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

Stephanie San Juan Branch Chief, Health Care Resources (HCR) Branch II Network Contracting Office (NCO) 21 Phone: 702-791-9000 x1893 Work Cell: 702-306-2733 Email: stephanie.sanjuan@va.gov

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

COR Responsibilities:

The COR for this contract is: Clarisse Mejia, Administrative Officer 4150 Clement Street SF.CA. 84121 Tel #: 415-221-4810 ext. 22091 VA Email: Clarisse.mejia@va.gov

The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.

The COR will maintain a record-keeping system of services by Clarisse Mejia. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

All contract administration functions will be retained by the VA.

SPECIAL CONTRACT REQUIREMENTS

The Contractors’ facility shall meet all federal, state and local fire and life safety codes and must be accessible and convenient for wheelchair patients and other handicapped or disabled Veterans.

Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and is provided here as a guide for Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

BILLING:

Invoice requirements and supporting documentation: Payment to the Contractor shall be made monthly, in arrears, upon receipt of a properly prepared invoice. Payment for services will be at the rates specified in the Schedule of Supplies/Services. The Contractor shall submit invoices using CMS Uniform Billing (UB-04) forms covering the services performed under this contract. The invoices shall contain the following information: Invoice number, PO Number , Vendor Code, Invoice Date, Currency, Amount to Pay, Description, Quantity, Unit, Unit price. Delivery Note(Delivery Note and Payment Due)

Contract Number and Purchase Order Number (if applicable) Name of Beneficiary and last four digits of the Social Security Number Itemized statement of services rendered by CPT Code and Rates Total Price

VENDOR ELECTRONIC INVOICE SUBMISSION METHODS:

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

Invoices will be electronically submitted to the Tungsten website at https://www.tungsten-network.com/us/support/ Tungsten direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135 Website: https://www.tungsten-network.com/us/support/ Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791 Email: vafscched@va.gov

PAYMENTS IN FULL/NO BILLING VA BENEFICIARIES:

The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.

The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third-party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Mohs Technician Services Contract Period: Base POP Begin: 05-01-2020 POP End: 04-30-2021

Mohs Technician Services Contract Period: Option 1 POP Begin: 05-01-2021 POP End: 04-30-2022

Mohs Technician Services Contract Period: Option 2 POP Begin: 05-01-2022 POP End: 04-30-2023

Mohs Technician Services Contract Period: Option 3 POP Begin: 05-01-2023 POP End: 04-30-2024

Mohs Technician Services Contract Period: Option 4 POP Begin: 05-01-2024 POP End: 04-30-2025

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in 32.608-2 of the Federal Acquisition Regulation in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the Government using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred which reasonably could have been avoided.

(m) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience.

(n) Title. Unless specified elsewhere in this contract, title to items furnished under this contract shall pass to the Government upon acceptance, regardless of when or where the Government takes physical possession.

(o) Warranty. The Contractor warrants and implies that the items delivered hereunder are merchantable and fit for use for the particular purpose described in this contract.

(p) Limitation of liability. Except as otherwise provided by an express warranty, the Contractor will not be liable to the Government for consequential damages resulting from any defect or deficiencies in accepted items.

(q) Other compliances. The Contractor shall comply with all applicable Federal, State and local laws, executive orders, rules and regulations applicable to its performance under this contract.

(r) Compliance with laws unique to Government contracts. The Contractor agrees to comply with 31 U.S.C. 1352 relating to limitations on the use of appropriated funds to influence certain Federal contracts; 18 U.S.C.