36C26121Q0598.docx

36C26121Q0598

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

662-22-1-826-0003 36C26121Q0598 07-01-2021 Angela Gerlitzki 808-539-1307 08-02-2021 09:00 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 X "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

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page Air Ambulance Services for the San Francisco Veterans Affairs Medical Center (SFVAMC) 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.

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

$0.00 See CONTINUATION Page X Jason T. Hill Contracting Officer Table of Contents

36C26121Q0598

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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 Department of Veterans Affairs 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 $3,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

The contractor will provide a price per statute mile which is inclusive of the services of qualified pilots and medical personnel as dictated by standard industry practices, Federal Aviation Administration, and Emergency Medical Services Regulatory Board to provide medical/nursing care that is required. The price per statute mile submitted by the contractor shall be all inclusive. See the Performance Work Statement (PWS) for additional details.

ITEM INFORMATION

Base Rate for Air Ambulance Service for pre-authorized Veterans Contract Period: Base POP Begin: 10-01-2021 POP End: 09-30-2022 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

MANUFACTURER PART NUMBER (MPN): NA

Rate Per Air Ambulance Statute Mile in addition to the Base Rate

POP Begin: 10-01-2021 POP End: 09-30-2022 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Base Rate for Air Ambulance Service for pre-authorized Veterans

POP Begin: 10-01-2022 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Rate Per Air Ambulance Statute Mile in addition to the Base Rate

POP Begin: 10-01-2022 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Base Rate for Air Ambulance Service for pre-authorized Veterans

POP Begin: 10-01-2023 POP End: 09-30-2024 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Rate Per Air Ambulance Statute Mile in addition to the Base Rate

POP Begin: 10-01-2023 POP End: 09-30-2024 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Base Rate for Air Ambulance Service for pre-authorized Veterans

POP Begin: 10-01-2024 POP End: 09-30-2025 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Rate Per Air Ambulance Statute Mile in addition to the Base Rate

POP Begin: 10-01-2024 POP End: 09-30-2025 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Base Rate for Air Ambulance Service for pre-authorized Veterans

POP Begin: 10-01-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Rate Per Air Ambulance Statute Mile in addition to the Base Rate

POP Begin: 10-01-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

B.3 PERFORMANCE WORK STATEMENT

SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER (SFVAMC)

AIR AMBULANCE SERVICES

June 28, 2021

1.0 SCOPE

1.1 The contractor will provide air ambulance (fixed wing) transportation services for authorized beneficiaries. The solicitation consists of one (1) medical facility, the San Francisco Veterans Affairs Medical Center (SFVAMC).

1.2 Air ambulance flights are expected to be one way Trips (patient leg only) if the authorized beneficiary is transferred to another VA facility. If return Air Ambulance service would be required, it would be the responsibility of the sending VA medical center to provide this under their current contracts. The price shall include all legs of transportation including ground ambulance to and from respective airports.

1.3 The contractor will be utilized for beneficiary travel if the SFVAMC places the order for services. The Government has no control over third-party private or public hospitals placing ambulance orders for eligible veteran beneficiaries, and these third-party hospitals may or may not elect to use this contract.

1.4 Most beneficiaries will be transported within the continental United States, with a few possible trips to locations, such as Hawaii and Alaska.

1.5 The Government intends to make one award. The resulting contract made against this solicitation will be an Indefinite Delivery Indefinite Quantity (IDIQ) firm-fixed price contract. A task order will be issued to fund the period of performance.

1.6 The following chart includes the estimated trips per year along with the guaranteed minimum amount. These guaranteed amounts apply to option periods as well. The minimum guarantee will be included in the first funded task order that is awarded against the IDIQ contract.

2.0 PERIOD OF PERFORMANCE

The base period task order is anticipated to commence on October 1, 2021 and end on September 30, 2022. The task order has four option periods.

3.0 DEFINITIONS

14 CFR Part 119: Title 14 of the Code of Federal Regulations Part 119, issued by the Federal Aviation Administration (FAA), prescribes the certification requirements an operator must meet in order to obtain and hold a certificate authorizing operations under Parts 121 or 135 and operation specifications for each kind of operation to be conducted in each class and size of aircraft.

14 CFR Part 121: Title 14 of the Code of Federal Regulations Part 121, issued by the Federal Aviation Administration (FAA), prescribes operating requirements governing the domestic, flag, and supplemental operations of each person who holds or is required to hold an Air Carrier certificate or operating certificate under Federal Aviation Regulations Part 119.

14 CFR Part 135: Title 14 of the Code of Federal Regulations Part 135, issued by the Federal Aviation Administration (FAA), prescribes rules governing commuter and on-demand operations of each person who holds or is required to hold an Air Carrier Certificate or Operating Certificate under FAA Part 119.

Air Ambulance: Fixed wing aircraft with a compartment that is designed and constructed to afford relative safety and comfort and to avoid aggravation of the patient’s condition. The aircraft, compartment, and personnel meet all applicable federal and state standards for medical air transport.

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

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

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.

CCT: Critical Care Transport, this usually will include the presence of a nurse or 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. The oversize ambulance must be capable of accommodating the following VA staff: MD, Nurse, Respiratory Therapist and Cardio Pulmonary Resuscitation (CPR) Performer.

CO / Contracting Officer: The person executing this contract on behalf of the Government and the only person authorized to make changes to the contract.

COR / Contracting Officer’s Representative: Person or persons authorized to act for the Contracting Officer within the limits of his / her authority.

Federal Acquisition Regulations (FAR): Is established for the codification and publication of uniform policies and procedures for acquisition by all executive agencies. The Federal Acquisition Regulations System consists of the Federal Acquisition Regulation (FAR), which is the primary document, and agency acquisition regulations that implement or supplement the FAR.

Federal Aviation Regulations (FARs): are rules prescribed by the Federal Aviation Administration (FAA) governing all aviation activities in the United States. The FARs is part of Title 14 of the Code of Federal Regulations (CFR). A wide variety of activities are regulated, such as airplane design, typical airline flights, pilot training activities, hot-air ballooning and even model rocket launches. The rules are designed to promote safe aviation, protecting pilots, passengers and the general public from unnecessary risk. They are also intended to protect the national security of the United States, especially in light of the September 11, 2001 attacks.

Federal Holidays: New Year’s Day, Martin Luther King Jr. Birthday, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, Christmas Day, Juneteenth, also any day determined by the President of the United States to be a Federal Holiday.

Ground Ambulance: Vehicles for emergency medical care which provide a driver compartment and a patient compartment that will accommodate an Emergency Medical Technician (EMT), Paramedic (or RN as needed) and two litter patients, so positioned that at least one patient can be given intensive line support during transit; equipment and supplies for emergency care at the scene as well as during transport, and two-way radio communication and equipment for light rescue procedures. The ambulance is designed and constructed to afford relative safety and comfort and to avoid aggravation of the patient’s condition.

Requesting Official: The requesting official is a medical care provider at a third-party (non-VA) hospital that has received authorization from the SFVAMC to request air ambulance services on behalf of the pre-determined eligible veteran/patient.

SFVAMC/San Francisco VA Medical Center: 4150 Clement Street, San Francisco, CA 94121

Trip: A trip is defined as the distance, “ONE WAY ONLY,” over which a beneficiary will be transported. In other words, a Trip is only the patient leg of transport. For all one-way trips ordered under this contract, the Contractor shall receive the base rate quoted under the “BASE RATE.” The Contractor shall also receive the mileage charge quoted under the “Mileage RATE.” A Trip also includes the ground ambulance transportation to/from the hospital to/from the airport.

4.0 DESCRIPTION OF WORK

4.1 The Contractor shall provide ALS/BLS/CCT pre-arranged air ambulance service twenty-four (24) hours per day, seven (7) days per week, including all holidays for beneficiaries of the VA.

4.2 The Contractor shall provide passenger air charter service and related passenger services to assist the Government in meeting its travel needs from and around the SFVAMC.

4.3 Contractor shall use contractor-owned stretchers, wheelchairs, linens or any other items required in transporting patient(s) from one place to another.

4.4 The contractor shall provide all legs of transportation including ground ambulance to and from respective airports.

4.5 All travel will be a one-way Trip. The contractor awarded a contract shall have an air ambulance located within San Francisco and or neighboring Counties. The contractor may propose another location if the response time can be met.

5.0 ORDERS FOR SERVICE

5.1 The Requesting Official or authorized SFVAMC representative(s) will place telephone or fax requests (orders) for contract services with the Contractor’s dispatch office. The request for services shall specify the originating point and final destination.

5.2 For orders placed by a Requesting Official, the Contractor shall verify that the telephone request has been authorized by the SFVAMC either by confirming pre-authorization with the Requesting Official at the time of the telephone request or by verifying with any SFVAMC authorized personnel listed below:

5.2.1 SFVAMC – Joseph Singh (415) 750-2155

5.2.2 SFVAMC – AOD after hours (415) 750-2052

5.3 Staff members designated to authorize air ambulance transport at VA expense will be detailed by name for the SFVAMC. These names will be provided to the Contractor at the initiation of the contract and the contractor MUST ensure that authorizations are accepted only from staff so designated. The contractor will supply the SFVAMC Beneficiary Travel office(s) with a contact information list upon initiation of the contract.

6.0 RATE

6.1 For all one-way trips ordered under this contract, the Contractor shall receive the base rate quoted under the “BASE RATE.” The “BASE RATE” shall constitute full compensation for ONE-WAY trips. The Contractor shall also receive the mileage charge quoted under the “Mileage RATE” for any one-way trip.

6.2 This is a firm-fixed price contract. Quoted rates listed in Section B.2 Price Schedule shall not be modified. Additional charges for sub-contractor services, to transport the plane to the origin destination, or for transport after final destination are not authorized under this contract. In addition, the Government shall not receive any invoices from sub-contractors. There is no privity of contract between the Government and any sub-contractors.

7.0 CANCELLATION

7.1 If the order is cancelled by the Requesting Physician, SFVAMC, the Contractor will be paid the base rate plus actual nautical miles traveled at the time of the cancellation, plus the necessary nautical miles the Contractor’s aircraft must travel to return to its starting location. The return mileage is only reimbursable if the contractor does not have another destination on its flight plan.

8.0 PERSONNEL

8.1 The Contractor will provide as required the necessary licenses/certificates, competencies, privilege and credentialing in accordance with applicable State(s) and Federal regulation for each employee that will perform services under this contract.

9.0 INFECTION CONTROL REQUIREMENTS

9.1 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.

9.2 Tuberculosis Screening and Testing.

9.2.1 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.

9.2.2 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.

9.2.3 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.

9.2.4 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.

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

10.0 LICENSES, CERTIFICATIONS, AND INSURANCE

10.1 All work related to this contract will be performed by the Contractor in accordance with any applicable FAA, U.S. Department of Transportation, or OSHA regulations, as well as applicable State health and safety regulations, health care accreditation standards (JCAHO or equivalent accreditation organization) and standard industry practices as defined by the Association of Air Medical Services for air ambulance transportation.

10.2 This solicitation applies to non-scheduled operations of air transportation conducted under:

· 14 CFR Part 121 (“Supplemental Operations”) 14 CFR Part 135 Air Carrier and Operator Certification (faa.gov)

· 14 CFR Part 135 (“Commuter and On-Demand Operations”) 14 CFR Part 121 Air Carrier Certification (faa.gov)

10.3 FARs Part 135 Operators must be in compliance with applicable regulations as outlined in Federal Aviation Regulations Part 135: Operating Requirements: Commuter & On-Demand Operations & Rules Governing Persons on Board Such Aircraft.

10.4 FARs Part 121 Operators must be in compliance with applicable regulations as outlined in Federal Aviation Regulations Part 121: Operating Requirements: Domestic, Flag, and Supplemental Operations.

10.5 Medical Standards – refer to Federal Aviation Regulations (FARs) Part 61.23, Subpart A: “Medical Certificates: Requirement and Duration”

· Medical Class (1st, 2nd, or 3rd)

· Medical Date (FAA certified physician check)

10.6 Air Ambulance Pilot - Shall have a valid operator's license in accordance with Federal, State and local government requirements for their place of operation, for the services they perform.

10.7 EMTs - Shall be certified, licensed or otherwise officially recognized by the local, state or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

10.8 Ambulance Driver - Shall have a valid operator's or chauffeur's license in accordance with Federal, State and local government requirements for their place of operation, for the services they perform.

10.9 Contractor - Shall maintain personal liability, automobile liability, and property damage insurance, as prescribed by the laws of the State of California, and in accordance with VAAR 852.228-71, VAAR 852.237-7, and VAAR 852.237-70.

10.9.1 Liability Insurance. The Operator shall maintain, or cause to be maintained at its sole expense, bodily injury and property damage liability insurance.

10.9.2 Hull Insurance. The Operator shall maintain, or cause to be maintained at its sole expense, all risks aircraft hull insurance in an amount equal to the value of the aircraft. Such policy shall designate the Operator and any first lien mortgage holder as loss payees as their interests may appear.

10.9.3 Insurance Certificates. The Operator shall provide the VA with a Certificate of Insurance evidencing the insurance coverage required upon execution hereof and immediately upon the VA’s or ordering agency’s request at any time thereafter.

10.9.4 Workers Compensation. The Operator shall maintain workers compensation insurance providing applicable statutory benefits for all employees performing services. The cost of such workers compensation insurance premiums is the Operator’s responsibility.

11.0 DESIGNATION OF CONTRACTING OFFICER REPRESENTATIVE (COR)

11.1 The Contracting Officer (CO) will appoint a Contracting Officer Representative (COR) to perform tasks related to the execution and surveillance of this contract. The COR will be designated to represent the Contracting Officer (CO) in furnishing technical guidance and advice under this contract. The foregoing is not be construed as authorization to interpret or furnish advice and information to Contractor relative to the financial or legal aspect of the contract. Those matters are the responsibility of the CO and shall not be delegated.

11.2 The CO is responsible for the administration of this contract. The CO is the only individual authorized, to extent indicated in this contract, to take actions on behalf of the Government, which may result in changes in the contract terms, to include deviation from the statement of work, details, and performance schedules. Communications pertaining to contractual matters shall be addressed to the CO. No changes in or deviation from the scope of work shall be affected without a written modification to the contract executed by the CO. No oral statements of any person whosoever will in any matter or degree, modify or otherwise affect the terms of this contract.

11.3 The Contractor will receive a copy of Delegation Letter which will identify the COR appointed by the CO.

12.0 INSPECTION, QUALITY, AND PERFORMANCE STANDARDS

12.1 The Government has the right to inspect the contractor premises, maintenance records of medical equipment and aircraft(s), flight logs, and dispatch records being used for the contracted services. Furthermore, annually the contractor must provide proof of insurance (see paragraph 9.9 and Clauses 852.228-71, 852.237-7, and 852.237-70 for further details on insurance requirements) and copies of any licenses for all staff providing services under this contract upon request of the COR.

12.2 Contractor will ensure that each beneficiary is treated in a professional manner, keeping in mind diversity of our beneficiaries. Each beneficiary will be treated with the highest quality of care and standards established in the industry. Some of the areas to be assessed are:

a. Patient safety

b. Medical services

c. Equipment and aircraft maintenance program

12.3 The last month of each contract year the Contracting Officer will review contract compliance reports submitted by the COR. The review will employ various monitoring methods but will specifically include complaints and timeliness.

13.0 INVOICING/DELIVERABLES

13.1 The Contractor shall furnish the following information to the authorizing facility:

13.1.1 Contract Number and Purchase Order Number

13.1.2 Date of flight and number of statute miles flown.

13.1.3 Name and phone number of the authorized ordering Patient Travel Coordinator and facility.

13.1.4 Originating and termination points.

13.1.5 Name and social security number of each patient.

13.1.6 Name(s) of ambulance companies providing ground transportation.

13.1.7 An in-flight medical attendant’s report of the patient’s status, including vital signs, level of consciousness, drugs administered, details of therapeutic intervention, and the names and qualifications of all attendants working under the delivery order.

13.1.8 Any unusual circumstances encountered during the flight, including, but not limited to, inordinate altitudes flown, turbulence, and times associated with these abnormal conditions.

13.2 After all work has been completed the Contractor will furnish the information listed above, along with the delivery order invoice, directly to the Patient Travel Coordinator who placed the call order. Invoices will also be submitted electronically through the Tungsten OB10 system (see section 13.3) for payment. Do not include the information listed in 13.1 with your invoice. The invoice shall be submitted no later than 15 working days after completion of the call order.

13.3 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

Additional Info: Air ambulance transport would be paid by the VA for any veteran requiring emergency transport to a higher level of care. The only time the VA will not be the payor is when the person is a non-veteran (e.g., CHAMPVA, Humanitarian Emergency). In regards to alternative insurance plans that veterans may hold, the VA has no way to predict the percentage of veterans with outside insurance as this changes constantly each year depending on the Financial Means Test results for each veteran.

14.0 BUSINESS RELATIONS

14.1 The working relationship will be assessed based on beneficiary and/or travel coordinator satisfaction. This will include direct professional interaction between contractor and contracting officer. A few of the other requirements of the contract to be monitored, which is not directly related to cost, schedule, or performance are:

1. Integration and coordination of all activity needed to execute the contract, change proposal submissions, and the contractor’s history of professional behavior with all parties.

1. Actively work to eliminate roadblocks to ensure excellent performance.

15.0 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), PRIVACY RULE, AND SECURITY RULE

15.1 Whereas the Contractor will have access to Business Associate Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) that is subject to protection under regulations issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164, Subparts A and E, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), and 45 CFR Parts 160 and 164, Subparts A and C, the Security Standard (“Security Rule”); and whereas, Department of Veterans Affairs Veterans Health Administration is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45 CFR 160.103, the Contractor will be required to complete the blanks, sign, date and provide a completed Business Associate Agreement with their quotation or proposal (as provided as an attachment to this solicitation).

16.0 PATIENT PRIVACY AND CONFIDENTIALITY

16.1 All "patient papers" transported with the patient are confidential in accordance with HIPAA. Contractor's personnel may review these records for assessment and treatment purposes only. Appropriate administrative and medical information will be provided to the Contractor for patient transport. If the medical record is transported with the patient, it may be used as a source of information if the situation warrants (i.e. emergent care while in-route). In all other instances, all documents will remain intact and sealed.

17.0 RELEASE OF MEDICAL INFORMATION

17.1 The paramedics shall only release medical information obtained during the course of this contract to other VA or medical treatment facility staff involved in the care and treatment of that individual patient.

18.0 QUALITY CONTROL (QC)

18.1 The contractor shall develop, submit for contracting office acceptance, and maintain a quality control program to ensure the requirements of this contract are performed in accordance with established standards. The contractor shall develop and implement procedures to identify, prevent and ensure non-recurrence of defective services. As a minimum the contractor shall develop quality control procedures (QCP) addressing the areas identified in the service summary. The contractor shall make appropriate modifications (at no additional costs to the government) and obtain acceptance of the plan by the CO. The VA shall reserve the right to determine contractor QCPs unacceptable at any time during contract performance. If a QCP is found to be unacceptable, the contractor shall be notified, and the CO will take action to enforce the inspection of services clause requiring an inspection system acceptable to the government

19.0 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

19.1 QASP is a systematic method used by the Government to evaluate Contractor’s actions and performance based on Performance Work Statement (PWS) requirements. The QASP is designed to provide an effective method of monitoring contractor performance for each listed objective on the PWS. A QASP is based on the premise the Government desires to maintain a quality standard in providing air ambulance services.

19.2 For the tasks listed in the Performance Requirement Table (PRT) below, the COR will follow the methods of surveillance specified in this contract.

19.3 When a required service in the PRT indicates defective performance, the COR will require the contract manager or representative at the site to document the observation and forward to the Contracting Officer to maintain in the file. The documentation of the observation does not necessarily constitute concurrence with the observation, only acknowledgment that he or she has been made aware of the defective performance. Government surveillance of tasks not listed in the PRT or by methods other than those listed in the PRT (such as provided for by the Inspection of Services clause) may occur during the performance period of this contract. Such surveillance will be done according to standard inspection procedures or other contract provisions. Any action taken by the contracting officer as a result of surveillance will be in accordance with the terms of this contract.

Performance Requirements Table

And Customer Complaint COR shall monitor vendor personnel and transport performance of patient transport services.

COR shall inspect to ensure vender compliance.

SS-3. Documentation: Preparation of all required run sheets including, but not limited to timeliness, legibility, accuracy, content and signature.

13, 15, 16, 17

90% Periodic Inspection by COR to review run sheets completed by contract personnel to ensure that standards are practiced.

COR shall inspect to ensure vender compliance.

20.0 MODIFICATIONS

20.1 The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The contractor shall communicate with the Contracting Officer in all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes, which will affect price, quantity, or quality of performance of this contract. In the event the contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustments will be made in the contract price to cover any increase in costs incurred as a result thereof.

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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…