36C26121Q0192 Solicitation.docx

36C26121Q0192

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

662-21-1-826-0016

36C26121Q0192 02-03-2021 Angela Gerlitzki 808-539-1307 03-03-2021

9AM HST

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Pacific Islands Health Care System 459 Patterson Rd Honolulu HI 96819-1522

X

621910 $16.5 Million

N/A

"See Delivery Schedule"

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Pacific Islands Health Care System 459 Patterson Rd Honolulu HI 96819-1522

FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page Ground Ambulance Services for the VA San Francisco Health Care System (SFVAHCS) in accordance with the Performance Work Statement (PWS).

Quote instructions are provided in provision 52.212-1.

Evaluation factors are provided in provision 52.212-2.

Base Period of Performance: 4/1/2021 - 3/31/2022

The Government intends to award a single Indefinite Delivery Indefinite Quantity (IDIQ) contract. The guaranteed minimum for the entire contract is $1,000.00.

See CONTINUATION Page

Jason T. Hill Contracting Officer

Table of Contents

36C26121Q0192

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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 Angela Gerlitzki, Contract Specialist

VA Sierra Pacific Network (VISN 21) VA Pacific Islands Health Care System 3375 Koapaka Street Suite F250 Honolulu HI 96819-1522

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.

Invoicing: All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp.

Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

· Tungsten e-Invoice Setup Information: 1-877-489-6135

· Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

· FSC e-Invoice Contact Information: 1-877-353-9791

· FSC e-invoice email: vafsccshd@va.gov ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

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B.2 PRICE/COST SCHEDULE

The guaranteed minimum award amount for this contract is $1,000.00. The maximum aggregate value of orders that can be placed under this contract is $2,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

PLEASE NOTE: The contract maximum is an amount higher than the Government's anticipated costs based on current needs; it is a higher amount to allow for the addition of other locations within VA San Francisco Health Care System (SFVAHCS) the future should the Government's needs increase.

It is understood that the prices listed in the accepted Schedule shall be inclusive of any and all ferry, bridge, tunnel or road toll charges. Contractor shall not bill the VA for any such separate charges.

All quantities are estimated yearly quantities and may change based on the VA San Francisco’s need.

Base Period: April 1, 2021 – March 31, 2022, Humboldt County

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 0001-0004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 0005.

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

TOTAL CLINS 0001-0008:

Base Period: April 1, 2021 – March 31, 2022 Sonoma, Marin, Napa & San Francisco Counties

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 0009-0012 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 0013.

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Base Period: April 1, 2021 – March 31, 2022 Mendocino County

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Ordering Period One (1): April 1, 2022 – March 31, 2023, Humboldt County

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 1001-1004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 1005.

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Ordering Period One (1): April 1, 2022 – March 31, 2023 Sonoma, Napa, Marin & San Francisco Counties

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 1009-1012 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 1013.

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Ordering Period One (1): April 1, 2022 – March 31, 2023 Mendocino County

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Ordering Period Two (2): April 1, 2023 – March 31, 2024, Humboldt County

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 2001-2004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 2005.

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Ordering Period Two (2): April 1, 2023 – March 31, 2024 Sonoma, Napa, Marin & San Francisco Counties

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 2009-2012 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 2013.

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Ordering Period Two (2): April 1, 2023 – March 31, 2024 Mendocino County

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Ordering Period Three (3): April 1, 2024 – March 31, 2025, Humboldt County

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 3001-3004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 3005.

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Ordering Period Three (3): April 1, 2024 – March 31, 2025 Sonoma, Napa, Marin & San Francisco Counties

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 3009-3012 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 3013.

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Ordering Period Three (3): April 1, 2024 – March 31, 2025 Mendocino County

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Ordering Period Four (4): April 1, 2025 – March 31, 2026, Humboldt County

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

Trips originate in Humboldt County (Eureka) with almost all destinations to SFVAMC.

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 4001-4004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 4005.

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Eureka CBOC to St. Joseph's Hospital Eureka (3 miles)

Ordering Period Four (4): April 1, 2025 – March 31, 2026 Sonoma, Napa, Marin & San Francisco Counties

The SFVAMC has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 4001-4004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 4013.

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Santa Rosa CBOC to Sutter Coast Hospital (6.3 miles)

Ordering Period Four (4): April 1, 2025 – March 31, 2026 Mendocino County

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

Trips originate in Mendocino County (Ukiah) with almost all destinations to SFVAMC.

B.3 PERFORMANCE WORK STATEMENT

AMBULANCE SERVICE

VETERANS AFFAIRS SAN FRANCISCO HEALTH CARE SYSTEM

2/2/2021

1. GENERAL SPECIFICATIONS

A. Purpose: The contractor will provide twenty-four (24) hour ambulance services as needed for beneficiaries of the Department of Veterans Affairs (DVA). These services are to assure appropriate transportation for authorized beneficiaries between designated sites. The contractor will provide Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) ambulance services to all of the defined areas and such service will include all labor, materials, equipment and supplies that might be required. The services will be classified as Standard or Urgent.

B. The contract covers one (1) medical facility: Veterans Affairs Medical Center San Francisco (SFVAMC). The contract is divided into the following Locations:

The medical facilities listed above are also responsible for Community Based Outpatient Clinics (CBOC) located around the facility. The CBOC locations are listed in Section 4(D)(2) below. Offerors are required to perform services for every county in a proposed location. You will not be considered for award if you cannot perform services for all counties in a certain Location

The resulting contract made against this solicitation will be an Indefinite Delivery Indefinite Quantity (IDIQ). A task order will be issued to fund the period of performance.

C. Estimated Dollar Value/Guaranteed Minimum/Maximum

The following chart includes the estimated trips per year. The guaranteed minimum for all locations combined is $1,000.00. This guaranteed amount applies to ordering periods as well. The minimum guarantee will be included in the first funded task order that is awarded against the Indefinite Delivery Indefinite Quantity contract.

D. Period of Performance

Five (5) Years.

2. DEFINITIONS

The contractor will provide ambulance service at all of the established levels of patient acuity - BLS, ALS, and ALS/Critical Care. The definitions of these acuity levels will be established within the specificity of industry standards. In general, the definitions are:

1. BLS: Basic Life Support, which includes service, provided by licensed/certified Emergency Medical Technicians (EMTs). ALL of the attendants on the vehicle will be a fully certified EMT as defined by California State laws/regulations, county regulations, and local ordinances.

2. ALS: Advanced Life Support which includes the BLS level but one of the attendants will be a licensed/certified paramedic.

3. Critical Care: Advanced Life Support, this usually will include the presence of a nurse or licensed physician plus the EMTs or paramedics. For patient transport involving PCI (Percutaneous Coronary Intervention) with Intra-aortic Balloon Pump Transport, an oversize “big box” ambulance will be required. Contractor must have the following staff available and ready for transport: Physician, mechanical circulatory support specialist, critical care transport registered nurse, critical care transport emergency medical technician. VA will not provide any staff during transport of patient.

4. Standard: An ambulance is dispatched within two hours upon call by the DVA. Dispatch times may vary upon agreement between the contractor and the DVA for long-distance transports greater than 100 miles.

5. Urgent Care (STAT) (“Urgent”): An ambulance is dispatched within one hour upon call by the DVA. This is an additional service to 1-3.

This requirement applies only if the contractor is currently offering these services in their service areas.

6. Definition of “Trips”:

a. From pickup location to delivery location (also a “one way trip”)

b. From pickup to delivery and return to pickup location (also a “round trip”).

3. SCOPE OF WORK

A. Performance Criteria:

1. The contractor shall provide ambulance services that meet the following requirements:

a. Response times will be based upon whether the transportation requested is Standard or Urgent.

b. Response time calculation: Response time will be calculated from the receipt of the telephonic request for service. At the time of the request, contractor shall acknowledge their ability to provide the service within the requested response time. If the contractor cannot provide the services for any reason, they must notify the VA staff person requesting the service of their inability to provide the service.

c. Waiting time: The contractor is expected to allow for waits of up to 15 minutes at either or both the trip origin and destination.

d. Trip documentation: The contractor shall document each transport with an appropriate document that specifies the date, patient name, social security number, time of pick-up, destination, time of drop-off, and any notes about issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided. The contractor shall leave a copy of this form with the authorized VA staff (or a copy will be mailed to the specified VA location). These forms will serve as documentation of the transport and will be a source document for reconciliation of the contractor’s filed claims for VA payment.

e. Ordering procedures: Authorized VA staff will telephonically notify the contractor of a request for service. The VA staff is responsible for reviewing and determining that a patient is an authorized beneficiary for transportation. The contractor must not transport any patient without first having VA authorization. (The contractor may propose the use of alternative ordering procedures/systems such as electronic notification. The VA may accept such procedures after consideration and the specific processes will be so documented if accepted.) Authorized VA staff may place orders at any time during the day or night. The contractor must be prepared to accept orders and to provide service 24 hours a day, 7 days per week. When placing orders, VA staff must specify any special services needed, such as oxygen, cardiac monitoring, etc. Additionally, if the request is to transport a patient needing restraint (Mental Health or medical) the specific needs must be specified.

f. Origin and Destination: Patients may be transported to or from any designated location within the defined service area. Most transports will be between VA facilities or between a VA facility and a community health resource. The VA staff will specify the points of origin and the destination of every trip.

g. Emergency diverts: The contractor may determine that a patient requires an emergency divert from a planned transport due to a medical emergency with the patient being transported. Such diversions are allowed as necessary, however, the contractor must notify the VA as soon as possible.

2. Routine Scheduling by the VA:

a. The VA will schedule routine trips when possible by 6:00p.m, the evening before services are required. The VA will provide a list of VA Beneficiaries, which includes but is not limited to pickup times.

b. The Contractor will send the schedule with any revisions to the VA by 8:00 pm.

B. Vehicle Standards and Equipment:

1. The contractor will provide services utilizing ambulances that are licensed and meet the minimum vehicle requirements mandated by the State of California, the California Highway Patrol Ambulance Service criteria, and any mandated local codes or industry standards.

2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with contract specifications and State laws, rules, regulations, and guidelines governing medical transport vehicles (ambulances). VA inspections of contractor facilities shall in no way constitute a warranty by the VA that the contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the Contractor’s use of equipment and vehicles which are in need of repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the Government.

3. The Ambulance will comply with GSA Specifications KKK-A-1822.

4. The Contractor that is providing ambulance services shall provide oxygen when it is requested by authorized VA personnel or required by the patient’s medical condition. Oxygen required for ambulance services shall be at the rate and price shown in the Schedule B of Services and Prices.

5. The Contractor shall not be permitted to borrow medical equipment from any medical facility. The Contractor shall provide all medications required while in transport, sheets and blankets and other equipment and supplies required for use while in transport, for direct patient care. Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medication with the VA. The prices quoted in Schedule B shall be inclusive of consumable used in transport. All vehicles used for critical patient care (i.e., ALS, BLS), shall include but not to be limited to , monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pump (IAPB), left ventricular assist devices (LVADs), oxygen and suction system equipment including portable oxygen suction, accessories and knowledge of impella devices.

C. Definition of Authorized Beneficiary:

1. The contractor will transport only one (1) patient per trip unless specifically authorized by a physician or other designated VA staff member. Authorization to use an ambulance for patient transportation MUST come by order of a VA physician. The process of issuing an authorization will come from a designated VA staff member (by direction of a VA physician) and the authorization MUST be obtained prior to the commencement of transportation.

The VA is solely responsible for the authorization of Veteran Beneficiaries. It is not the responsibility of the contractor to check eligibility of the Veteran.

2. When multiple patients are transported: More than one (1) patient may be transported only in those cases where a VA physician or other designated staff member approves. In these cases, reimbursement will be made at the rate NOT to exceed the cost of a single patient. If the transportation is beyond defined city limits, the longest distance over which one of the patients is transported may be claimed. (In the case of transportation beyond city limits, the contractor will ensure that the trips are scheduled so that the total distance traveled will result in the most economical charge to the VA.)

3. Staff members designated to authorize ambulance transportation at VA expense will be detailed by name for each of the VA facilities. These names will be provided at the initiation of the contract and the contractor MUST assure that authorizations are accepted only from the staff so designated.

D. Contractor Personnel Qualifications:

1. All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications by Federal, State, County, and local government entities from the place in which they operate. Contractor personnel shall meet these qualifications at all times while performing contract services.

2. The contractor shall not employ any persons for work on this contract if such employee is considered by the VA Contracting Officer (CO) to be a potential threat to the health, safety, security, or operations of the VA, its facilities or its staff.

a. Contractor’s employees shall understand, speak, read, and write the English language at a level, which promotes effective communication.

b. All contractor employees must have current and valid licenses/certifications before they can begin work on this contract. A copy of all certifications and/or other credentials shall be provided to the VA upon request by the CO or Contracting Officer Representative (COR).

c. No employee of the contractor can be a Federal employee nor can they have any conflict of interest either real or perceived.

d. Identification badges: All contractor employees shall wear appropriate identification that can clearly identify them by name, title, and by job performed.

e. Training: All contractor personnel will have ongoing documented training to maintain their appropriate levels of competency. Records and certifications shall be maintained by the contractor and available for VA inspection upon request. All attendants on the ambulances must have current CPR certification and basic first aid training along with their required certifications. Contractor employees must be trained on the appropriate handling of Mental Health patients and those patients that are developmentally disabled.

f. Organization Chart: Contractor shall provide a copy of their organization chart upon award of the contract. The chart will include names, addresses, and telephone numbers of the project manager and other key staff. When organization changes occur, the VA shall be provided a revised copy within ten (10) days of the official date of change.

3. During the period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training, certifications, licensing, and any other qualifications to the Contracting Officer.

4. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMT’s and Paramedic’s providing service under this contract shall hold a valid and current California EMT certificate. EMT’s shall comply with all re-certification and continuing education required under California Code of Regulations §100080 and any applicable local rules or ordinances.

5. Registered Nurse (RN): Personnel assigned by the Contractor to perform services by this contract shall be Licensed Registered Nurses in the State of California.

6. Ambulance Driver: All drivers shall have a valid State of California operator’s license to perform the services they perform, be capable of administering oxygen and have successfully completed the Standard and Advance First Aid Course of the American Red Cross or equivalent and be capable of providing necessary medical assistance to the attending medical care specialist.

E. Patient’s Rights:

1. The Contractor shall be courteous to VA beneficiaries and shall not smoke while transporting patients. Patients may bring a reasonable amount of equipment, such as wheelchairs and a personal suitcase.

2. The Contractor shall immediately notify the VA of any incidents involving injury to VA patients during transport.

3. The Contractor shall notify the COR, in writing within 24 hours of any complaint made by the patients or staff with regards to the ambulance service. The COR will report to the Contracting Officer. The Contracting Officer may request an investigation by the Contractor and a Plan of Correction.

4. The contractor shall be held responsible for patient welfare during transport. The contractor shall be held responsible for patient and/or Government property during transport. Any damaged or lost wheelchairs, walkers, crutches or personal belongings will be replaced by the contractor at no additional cost to the Government or beneficiary.

5. The Government requires the contractor to exercise extreme caution and care in the handling of patients. Any abuse of patients will be grounds for default action or Termination of the contract.

6. In the event a patient's condition worsens during transport, the Contractor shall transport the patient to the closest facility appropriate for the required care. In the event a patient should expire during transport the Contractor shall return with the patient back to the origin point.

F. Infection control requirements.

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

2. Tuberculosis Screening and Testing.

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

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

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

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

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

G. Authorized VA Personnel: Prior to performance, the Contracting Officer shall provide the Contractor with a list of names or position titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

H. Reimbursement:

(a) The Contractor shall be reimbursed for services in accordance with the Price Schedule in Section B. If the Price Schedule does not set forth a specific fixed route (for example from the VAPAHCS to the SFVAMC), then the Contractor will be reimbursed for the base rate plus the applicable mileage rate based on the distance of the transport. If there is a fixed price for a specific route (for example from the VAPAHCS to SFVAMC), then the Contractor will be reimbursed that fixed rate.

(b) Should the VA make a determination that a previously scheduled trip may be cancelled and a vehicle has already been dispatched to the designated pick-up point, the VA may notify the Contractor to cancel the order. For orders that are cancelled while the contractor is already in route to the designated pick-up, the contractor shall be entitled to receive 50% of the base rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.

(c) Should the Contractor arrive at the destination before VA cancels the order, or if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor's control, e.g., incorrect address, or patient absence, or patient refusal, then the Contractor shall receive 100% of base rate for a one-way trip as provided in Section B.

I. Escort: The VA reserves the right to have an escort, such as a relative, or care provider of beneficiary or VA staff accompany beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the sole judge in determining when an escort is required. There shall be no additional charge to the VA when escorts are authorized to travel with beneficiary. Contractor shall only be required to transport escort with patient and shall not be required to return the escort back to point of origin.

J. Substitution of Beneficiary: The VA reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract, to prevent delays, cancellations, or dry runs. There shall be no additional charge to the VA when such changes occur.

4. SPECIAL REQUIREMENTS

A. Ambulance Medical Equipment: Each ambulance shall have patient compartment facilities, oxygen, and suction systems and environmental climatic supplies as required by the Federal Specification for Ambulances, KKK-A-1822.

B. Invoicing Process: The contractor shall submit invoices on a monthly basis. Invoices can be prepared following the standard industry practice. Timely submission of invoices is essential for timely processing by the VA. The invoices must be complete and accurate or they will be returned unpaid for correction. The source documents, described above, will be used to authorize payment. Invoices will be submitted to the respective VA facilities as well as the VA Payment Center in Austin, Texas (VA-FSC):

Invoicing: All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp.

Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

· Tungsten e-Invoice Setup Information: 1-877-489-6135

· Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

· FSC e-Invoice Contact Information: 1-877-353-9791

· FSC e-invoice email: vafsccshd@va.gov

C. Licenses and other Certifications: The Contractor SHALL have all necessary license(s) and certifications for the service area.

Offerors for services in San Francisco shall comply with the requirements in San Francisco Health Code 903. For information contact the City and County of San Francisco, Emergency Medical Service Section, 68 12th Street, Suite 220, San Francisco, CA 94103, 415/ 355-2600.

D. Place of Performance: A MAP AND OTHER INFORMATION OF VISN 21 FACILITIES MAY BE FOUND AT:

http://www.visn21.va.gov/map.asp

1. The contractor (or subcontractor) awarded a contract for a certain location(s) shall have an ambulance(s) located within the city limits of facilities within the applicable location(s) (twenty-four hours a day, seven days a week). The contractor may propose another location if the response time can be met.

This requires approval of the Contracting Officer.