36C26121Q0013.docx

36C26121Q0013

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 ATTA

CHED

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. SIGNAT

URE 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

662-21-1-613-0001 36C26121Q0013 08-19-2020 Larry Facio

(916) 923-4553 09-04-2020 4:00pm

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 622110 $41.5 Million N/A X San Francisco VA Medical Center 4150 Clement Street San Francisco CA 94121

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 Contractor Shall Provide Mohs Technician Services In Accordance With Statement of Work.

X X Gary Basile

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:

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Mohs Micrographic Surgery Technician In Accordance With Performance Work Statement.

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Immunohistochemistry Staining (IHC).

Estimated of 30 cases per year (includes labor rate + Immunochemistry kit).

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Mohs Micrographic Surgery Technician In Accordance With Performance Work Statement.

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Immunohistochemistry Staining (IHC).

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Mohs Micrographic Surgery Technician In Accordance With Performance Work Statement.

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

Immunohistochemistry Staining (IHC).

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

Mohs Micrographic Surgery Technician In Accordance With Performance Work Statement.

Contract Period: Option 3 POP Begin: 10-01-2023 POP End: 09-30-2024

Immunohistochemistry Staining (IHC).

Contract Period: Option 3 POP Begin: 10-01-2023 POP End: 09-30-2024

Mohs Micrographic Surgery Technician In Accordance With Performance Work Statement.

Contract Period: Option 4 POP Begin: 10-01-2024 POP End: 09-30-2025

Immunohistochemistry Staining (IHC).

Contract Period: Option 4 POP Begin: 10-01-2024 POP End: 09-30-2025

Totals

Performance Work Statement Dermatology Mohs Surgery Services San Francisco VA Medical Center

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.

· Mohs Tech Minimum - Based on the number of lesions the VA is performing per day:

· For 5-7 lesions, a minimum of 1 technician is required.

· For 8 lesions and above, a minimum of two techs is required. The VA will provide two-week notice to the contractor if a second tech is required.

· If the VA is performing less than 5 lesions per day the contractor can invoice for a minimum of 5 lesions. NOTE: This does not apply to a second tech.

· The VA will pay the contractor based on the number of lesions and not the number of techs.

· If IHC staining is required, the Contractor shall provide Immunochemistry stain (Mart-1, CK5) per patient lesion site for IHC materials and staining.

· If IHC staining is required and the total number of cases for the day is above 6, A second technician will be scheduled to perform IHC staining. The VA will provide two-week notice to the contractor if a second technician is required.

· The need for additional technicians based on anticipated case size and patient safety is at the discretion of the VA Mohs Surgery Team and the contractor will be notified accordingly.

PLACE OF PERFORMANCE:

VA Medical Center San Francisco 4150 Clement Street San Francisco, CA. 94121.

PERIOD OF PERFORMANCE:

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

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

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

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 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.

ATTACHMENTS:

Attachment 1 Wage Determination No.: 2015-5638 (Rev. 16)

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Clause)

(End of Addendum to 52.212-4)

C.2 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JUN 2020)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.204–23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115–91).

(3) 52.204–25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (AUG 2019) (Section 889(a)(1)(A) of Pub. L. 115–232).

(4) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (NOV 2015).

(5) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553).

(6) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[X] (1) 52.203–6, Restrictions on Subcontractor Sales to the Government (JUN 2020), with Alternate I (OCT 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402).

[] (2) 52.203–13, Contractor Code of Business Ethics and Conduct (JUN 2020) (41 U.S.C. 3509).

[] (3) 52.203–15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (JUN 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.)

[x] (4) 52.204–10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUN 2020) (Pub. L. 109–282) (31 U.S.C. 6101 note).

[] (5) [Reserved] [X] (6) 52.204–14, Service Contract Reporting Requirements (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[] (7) 52.204–15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[X] (8) 52.209–6, Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (JUN 2020) (31 U.S.C. 6101 note).

[X] (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (41 U.S.C. 2313).

[] (10) [Reserved] [] (11)(i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (MAR 2020) (15 U.S.C. 657a).

[] (ii) Alternate I (MAR 2020) of 52.219-3.

[] (12)(i) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (MAR 2020) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a).

[] (ii) Alternate I (MAR 2020) of 52.219-4.

[] (13) [Reserved] [X] (14)(i) 52.219-6, Notice of Total Small Business Set-Aside (MAR 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020).

[] (15)(i) 52.219-7, Notice of Partial Small Business Set-Aside (MAR 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020) of 52.219-7.

[X] (16) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d)(2) and (3)).

[] (17)(i) 52.219–9, Small Business Subcontracting Plan (JUN 2020) (15 U.S.C. 637(d)(4)).

[] (ii) Alternate I (NOV 2016) of 52.219-9.

[] (iii) Alternate II (NOV 2016) of 52.219-9.

[] (iv) Alternate III (JUN 2020) of 52.219–9.

[] (v) Alternate IV (JUN 2020) of 52.219–9.

[] (18) 52.219-13, Notice of Set-Aside of Orders (MAR 2020) (15 U.S.C. 644(r)).

[X] (19) 52.219-14, Limitations on Subcontracting (MAR 2020) (15 U.S.C. 637(a)(14)).

[] (20) 52.219-16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)).

[] (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (MAR 2020) (15 U.S.C. 657f).

[X] (22)(i) 52.219-28, Post Award Small Business Program Rerepresentation (MAR 2020) (15 U.S.C 632(a)(2)).

[] (ii) Alternate I (MAR 2020) of 52.219-28.

[] (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (MAR 2020) (15 U.S.C. 637(m)).

[] (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (MAR 2020) (15 U.S.C. 637(m)).

[] (25) 52.219-32, Orders Issued Directly Under Small Business Reserves (MAR 2020) (15 U.S.C. 644(r)).

[] (26) 52.219-33, Nonmanufacturer Rule (MAR 2020) (15 U.S.C. 637(a)(17)) [X] (27) 52.222-3, Convict Labor (June 2003) (E.O. 11755).

[x] (28) 52.222–19, Child Labor—Cooperation with Authorities and Remedies (JAN 2020) (E.O. 13126).

[X] (29) 52.222-21, Prohibition of Segregated Facilities (APR 2015).

[X] (30)(i) 52.222–26, Equal Opportunity (SEP 2016) (E.O. 11246).

[] (ii) Alternate I (FEB 1999) of 52.222-26.

[X] (31)(i) 52.222–35, Equal Opportunity for Veterans (JUN 2020) (38 U.S.C. 4212).

[] (ii) Alternate I (JULY 2014) of 52.222-35.

[X] (32)(i) 52.222–36, Equal Opportunity for Workers with Disabilities (JUN 2020) (29 U.S.C. 793).

[] (ii) Alternate I (JULY 2014) of 52.222-36.

[X] (33) 52.222–37, Employment Reports on Veterans (JUN 2020) (38 U.S.C. 4212).

[X] (34) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496).

[X] (35)(i) 52.222-50, Combating Trafficking in Persons (JAN 2019) (22 U.S.C. chapter 78 and E.O. 13627).

[] (ii) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627).

[X] (36) 52.222-54, Employment Eligibility Verification (OCT 2015). (E. O. 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.)

[] (37)(i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C.6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

[] (ii) Alternate I (MAY 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

[] (38) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (JUN 2016) (E.O. 13693).

[] (39) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (JUN 2016) (E.O. 13693).

[] (40)(i) 52.223-13, Acquisition of EPEAT®-Registered Imaging Equipment (JUN 2014) (E.O.s 13423 and 13514).

[] (ii) Alternate I (OCT 2015) of 52.223-13.

[] (41)(i) 52.223-14, Acquisition of EPEAT®-Registered Televisions (JUN 2014) (E.O.s 13423 and 13514).

[] (ii) Alternate I (JUN 2014) of 52.223-14.

[] (42) 52.223-15, Energy Efficiency in Energy-Consuming Products (DEC 2007)(42 U.S.C. 8259b).

[] (43)(i) 52.223-16, Acquisition of EPEAT®-Registered Personal Computer Products (OCT 2015) (E.O.s 13423 and 13514).

[] (ii) Alternate I (JUN 2014) of 52.223-16.

[X] (44) 52.223–18, Encouraging Contractor Policies to Ban Text Messaging While Driving (JUN 2020) (E.O. 13513).

[] (45) 52.223-20, Aerosols (JUN 2016) (E.O. 13693).

[] (46) 52.223-21, Foams (JUN 2016) (E.O. 13693).

[x] (47) (i) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a).

[] (ii) Alternate I (JAN 2017) of 52.224-3.

[] (48) 52.225-1, Buy American—Supplies (MAY 2014) (41 U.S.C. chapter 83).

[] (49)(i) 52.225-3, Buy American—Free Trade Agreements—Israeli Trade Act (MAY 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43.

[] (ii) Alternate I (MAY 2014) of 52.225-3.

[] (iii) Alternate II (MAY 2014) of 52.225-3.

[] (iv) Alternate III (MAY 2014) of 52.225-3.

[] (50) 52.225–5, Trade Agreements (OCT 2019) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

[X] (51) 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

[] (52) 52.225–26, Contractors Performing Private Security Functions Outside the United States (OCT 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

[] (53) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150).

[] (54) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150).

[X] (55) 52.229–12, Tax on Certain Foreign Procurements (JUN 2020).

[] (56) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505, 10 U.S.C. 2307(f)).

[] (57) 52.232-30, Installment Payments for Commercial Items (JAN 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)).

[X] (58) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (Oct 2018) (31 U.S.C. 3332).

[] (59) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (Jul 2013) (31 U.S.C. 3332).

[] (60) 52.232-36, Payment by Third Party (MAY 2014) (31 U.S.C. 3332).

[] (61) 52.239-1, Privacy or Security Safeguards (AUG 1996) (5 U.S.C. 552a).

[] (62) 52.242-5, Payments to Small Business Subcontractors (JAN 2017)(15 U.S.C. 637(d)(13)).

[] (63)(i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631).

[] (ii) Alternate I (Apr 2003) of 52.247-64.

[] (iii) Alternate II (FEB 2006) of 52.247-64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[X] (1) 52.222-41, Service Contract Labor Standards (AUG 2018) (41 U.S.C. chapter 67).

[X] (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

[X] (3) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards—Price Adjustment (Multiple Year and Option Contracts) (AUG 2018) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

[] (4) 52.222-44, Fair Labor Standards Act and…