36C26123Q0407_1.docx

36C26123Q0407

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.

UEI:

EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C261-22-AP-3981

36C26123Q0407 03-03-2023 Amanda Hildreth 7027919000 03-24-2023

10 AM

PDT

612MCP

Department of Veterans Affairs Network Contracting Officer (NCO) 21 VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609 X X 621610 $16.5 Million N/A X Delivery to the Veteran

00261 Department of Veterans Affairs Network Contracting Office 21 Southern Nevada Healthcare System 6900 N. Pecos Road, Building 6 North Las Vegas NV 89086

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971 See CONTINUATION Page VA San Francisco Health Care System - San Francisco Durable Medical Equipment Services Notice of total Small Business set-aside applies to all items in this solicitation.

POC: Amanda Hildreth amanda.hildreth@va.gov The guaranteed minimum award amount is $1,000 The ceiling (maximum) value is $6,000,000 All questions are due by 12:00 PM Pacific on 3/10/2023 Late questions will not be answered. Questions will only be accepted via email.

Send all questions to the POC listed above.

See CONTINUATION Page x X Amanda J. Hildreth Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Amanda Hildreth Department of Veterans Affairs Network Contracting Officer (NCO) 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.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Fee for delivery of durable medical equipment (DME) from VA/contractor warehouse to the Veteran's address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

Contract Period: Ordering Period 1 POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

MANUFACTURER PART NUMBER (MPN): NA

ORDERING PERIOD #1

Fee for delivery - drop off ONLY. No set up and training. The unit of measure (UOM) is each job.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency delivery and set up of durable medical equipment needed within four (4) hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited delivery and set up needed within 24 hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Pickup of durable medical equipment (DME) within 50 miles of Distribution Center/VA clinic. This fee includes inspection, and cleaning prior to repair or storage at contractor's facility or in the appropriate VA facility as instructed by VA authorized personnel. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is per each job.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The contractor shall be reimbursed for mileage that exceeds 50 miles from the Distribution Center/VA clinic for deliveries and pickups made. The mileage shall be calculated using the distances provided by MapQuest or equivalent software that the following website: www.mapquest.com. The one-way reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-- www.gsa.gov. When multiple Jobs routes are consolidated Mapquest routes sheets with waypoints must be submitted for mileage reimbursements.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for routine repair assessment. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Labor costs required to complete repairs. Routine, expedited and emergency labor costs are to be billed at the same rate and shall be billed in 15 min units.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Scooter/Power Operated Vehicle (POV) as defined by Medicare guidelines.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Captains Seat as defined by Medicare guidelines.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Rehab Seat as defined by Medicare guidelines

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 3 as defined by Medicare guidelines

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 4 as defined by Medicare guidelines

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 5 as defined by Medicare guidelines.

POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for delivery of durable medical equipment (DME) from VA/contractor warehouse to the Veteran's address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

Contract Period: Ordering Period 2 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

ORDERING PERIOD #2

Fee for delivery - drop off ONLY. No set up and training. The unit of measure (UOM) is each job.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency delivery and set up of durable medical equipment needed within four (4) hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited delivery and set up needed within 24 hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Pickup of durable medical equipment (DME) within 50 miles of Distribution Center/VA clinic. This fee includes inspection, and cleaning prior to repair or storage at contractor's facility or in the appropriate VA facility as instructed by VA authorized personnel. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is per each job.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The contractor shall be reimbursed for mileage that exceeds 50 miles from the Distribution Center/VA clinic for deliveries and pickups made. The mileage shall be calculated using the distances provided by MapQuest or equivalent software that the following website: www.mapquest.com. The one-way reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-- www.gsa.gov. When multiple Jobs routes are consolidated Mapquest routes sheets with waypoints must be submitted for mileage reimbursements.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for routine repair assessment. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Labor costs required to complete repairs. Routine, expedited and emergency labor costs are to be billed at the same rate and shall be billed in 15 min units.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Scooter/Power Operated Vehicle (POV) as defined by Medicare guidelines.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Captains Seat as defined by Medicare guidelines.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Rehab Seat as defined by Medicare guidelines

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 3 as defined by Medicare guidelines

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 4 as defined by Medicare guidelines

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 5 as defined by Medicare guidelines.

POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for delivery of durable medical equipment (DME) from VA/contractor warehouse to the Veteran's address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

Contract Period: Ordering Period 3 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

ORDERING PERIOD #3

Fee for delivery - drop off ONLY. No set up and training. The unit of measure (UOM) is each job.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency delivery and set up of durable medical equipment needed within four (4) hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited delivery and set up needed within 24 hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Pickup of durable medical equipment (DME) within 50 miles of Distribution Center/VA clinic. This fee includes inspection, and cleaning prior to repair or storage at contractor's facility or in the appropriate VA facility as instructed by VA authorized personnel. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is per each job.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The contractor shall be reimbursed for mileage that exceeds 50 miles from the Distribution Center/VA clinic for deliveries and pickups made. The mileage shall be calculated using the distances provided by MapQuest or equivalent software that the following website: www.mapquest.com. The one-way reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-- www.gsa.gov. When multiple Jobs routes are consolidated Mapquest routes sheets with waypoints must be submitted for mileage reimbursements.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for routine repair assessment. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Labor costs required to complete repairs. Routine, expedited and emergency labor costs are to be billed at the same rate and shall be billed in 15 min units.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Scooter/Power Operated Vehicle (POV) as defined by Medicare guidelines.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Captains Seat as defined by Medicare guidelines.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Rehab Seat as defined by Medicare guidelines

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 3 as defined by Medicare guidelines

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 4 as defined by Medicare guidelines

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 5 as defined by Medicare guidelines.

POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for delivery of durable medical equipment (DME) from VA/contractor warehouse to the Veteran's address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

Contract Period: Ordering Period 4 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

ORDERING PERIOD #4

Fee for delivery - drop off ONLY. No set up and training. The unit of measure (UOM) is each job.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency delivery and set up of durable medical equipment needed within four (4) hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited delivery and set up needed within 24 hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Pickup of durable medical equipment (DME) within 50 miles of Distribution Center/VA clinic. This fee includes inspection, and cleaning prior to repair or storage at contractor's facility or in the appropriate VA facility as instructed by VA authorized personnel. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is per each job.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The contractor shall be reimbursed for mileage that exceeds 50 miles from the Distribution Center/VA clinic for deliveries and pickups made. The mileage shall be calculated using the distances provided by MapQuest or equivalent software that the following website: www.mapquest.com. The one-way reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-- www.gsa.gov. When multiple Jobs routes are consolidated Mapquest routes sheets with waypoints must be submitted for mileage reimbursements.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for routine repair assessment. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Labor costs required to complete repairs. Routine, expedited and emergency labor costs are to be billed at the same rate and shall be billed in 15 min units.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Scooter/Power Operated Vehicle (POV) as defined by Medicare guidelines.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Captains Seat as defined by Medicare guidelines.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Rehab Seat as defined by Medicare guidelines

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 3 as defined by Medicare guidelines

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 4 as defined by Medicare guidelines

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 5 as defined by Medicare guidelines.

POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for delivery of durable medical equipment (DME) from VA/contractor warehouse to the Veteran's address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

Contract Period: Ordering Period 5 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

ORDERING PERIOD #5

Fee for delivery - drop off ONLY. No set up and training. The unit of measure (UOM) is each job.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency delivery and set up of durable medical equipment needed within four (4) hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited delivery and set up needed within 24 hours from VA/contractor warehouse to the Veteran's address. This fee shall include set-up and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is each job.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Pickup of durable medical equipment (DME) within 50 miles of Distribution Center/VA clinic. This fee includes inspection, and cleaning prior to repair or storage at contractor's facility or in the appropriate VA facility as instructed by VA authorized personnel. Fee is inclusive of jobs that include stairs or require multiple technicians. The unit of measure (UOM) is per each job.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The contractor shall be reimbursed for mileage that exceeds 50 miles from the Distribution Center/VA clinic for deliveries and pickups made. The mileage shall be calculated using the distances provided by MapQuest or equivalent software that the following website: www.mapquest.com. The one-way reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-- www.gsa.gov. When multiple Jobs routes are consolidated Mapquest routes sheets with waypoints must be submitted for mileage reimbursements.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for routine repair assessment. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for emergency repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Fee for expedited repair assessment of DME, including emergency calls after hours. This is a flat fee and includes the travel to the Veteran's residence within 50 miles (one-way). Fee will include preparation of repair quote. The unit of measure (UOM) is each job. Billing for actual repair time is included in CLIN 0010.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Labor costs required to complete repairs. Routine, expedited and emergency labor costs are to be billed at the same rate and shall be billed in 15 min units.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Scooter/Power Operated Vehicle (POV) as defined by Medicare guidelines.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Captains Seat as defined by Medicare guidelines.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 2 with Rehab Seat as defined by Medicare guidelines

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 3 as defined by Medicare guidelines

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 4 as defined by Medicare guidelines

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

Set up and delivery of Power Wheelchair Group 5 as defined by Medicare guidelines.

POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q999 - Medical - Other

The guaranteed minimum award amount for this contract is $1,000. The maximum aggregate value (Ceiling) of orders that can be placed under this contract is $6,000,000. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

PERFORMANCE WORK STATEMENT

VA San Francisco Health Care System (VASFHCS) The U.S. Department of Veterans Health Administration (VHA)

1. SCOPE

1.1 Department of Veteran Affairs VA San Francisco Health Care System (VASFHCS) has an ongoing requirement for the pickup, delivery, storage, repair, and routine service of Durable Medical Equipment (DME) to veteran patients served by its seven medical centers and its associated outpatient clinics. The total number of DME delivered to Veterans for each VA Health Care System (VAHCS) is subject to change throughout the life span of this contract. Prior to the award, the Contractor must have The Joint Commission (TJC) or equivalent and must have the Center for Medicare and Medicaid Services (CMS) accreditation. Written documentation must be provided to support this requirement.

1.2 The Government intends to award a single firm fixed-priced Indefinite Delivery, Indefinite Quantity contract (IDIQ) contract for the health care system as identified in paragraph 3.4 pursuant to this solicitation. The period to be covered by this contract will contain five (5) order periods. The Department of Veterans Affairs reserves the right to exercise the option years, subject to the availability of funds.

1.3 This contract is for non-personal services. It does not create employment rights with the U.S. Government whether actual, inherent, or implied. By agreeing to perform the services described in these specifications, the Contractor acknowledges that he/she is not, and shall not become, an employee of the U.S. Government. The Contractor further agrees that he/she shall not bring any cause of action in any forum claiming that he/she has become an employee of the U.S. Government.

This contract is a “non-personal services contract” as defined in FAR 37.101. It is, therefore, understood and agreed that the Contractor and/or the Contractor’s employees or subcontractor:

a. Shall perform the services specified herein as Independent Contractors, not as employees of the government.

b. Shall manage and administer the work required and bear sole responsibility for complying with all technical, schedule, or financial requirements or constraints attendant to the performance of this contract.

c. Shall be free from supervision or control by any government employee with respect to the manner or method of performance of the services specified; but

d. Shall, pursuant to the government’s right and obligation to inspect, accept, or reject the work, comply with such general direction of the Contracting Officer, or the duly authorized representative of the Contracting Officer as is necessary to ensure accomplishment of the contract objectives.

2. GENERAL REQUIREMENTS

2.1 Contractor shall provide all labor, parts, equipment, transportation, fuel, and supervision necessary to provide storage, delivery set up, in-house instruction, and/or pick-up of durable medical equipment for VA beneficiaries of the VAHCS, in accordance with the terms, conditions, special provisions, and schedule contained herein.

2.2 The vendor shall have (or put in place within one calendar month) an electronic computer system that shows all VA required forms and documentation. This system shall be accessible to all VA personnel, as determined by the VA COR, at no cost to the Government, with access codes provided by the Contractor. The system shall be secure and meet all applicable VA IT rules and regulations and HIPPA, privacy rules and regulations. This system does not preclude VA patient information being provided on a requested basis through PKI encrypted e-mail and/or by secure fax machine.

2.3 This is an Indefinite Delivery Indefinite Quantity (IDIQ) contract, quantities shown in Appendix A are estimates only. VA makes no commitment concerning the minimum and/or maximum quantity of deliverables and/or services required herein; however, will comply with the minimum guarantee as specified in the contract. The amount of services required under the terms of an awarded contract shall be determined solely by the VA.

2.4 Accreditation Requirements This contract requires The Joint Commission (TJC) accreditation and other regulatory requirements regarding worker competency, the Contractor must perform the required work in accordance with TJC and CMS standards. The Contractor must demonstrate that it has met and/or exceeds TJC and CMS requirements; and provide documented evidence that it meets TJC requirements for delivery, set up, repair, pick-up, and storage of durable medical equipment. TJC standards can be found at http://www.jointcomission.org/.

2.5 The VAHCS will purchase DME devices that are part of the National Prosthetic Clinical Management Program (PCMP) contracts and/or Federal Supply Schedule (FSS) contracts, including Hospital Beds, Scooters, Standard, Rehab, and Power Wheelchairs – prior to any possible equipment purchases from the Contractor. The Government-Owned DME may be new or retrieved and refurbished. DME shall include, but not be limited to those in paragraph 5.7.

3. AREA OF RESPONSIBILITY

3.1. The contractor will provide services for VASFHCS VA Health Care System patients at sites listed in paragraph 3.4. The service area includes the catchment areas, regardless of where the patient resides. Contractors shall have a facility or resources physically located in the geographic area in which they shall provide service. Non-territory requests shall be required from time to time and the Contractor shall accept these "non-territory" Veterans at that Contractor’s awarded price. VA reserves the right to assign these Patients to any Contractor.

3.2 All services shall be performed in the veteran's place of residence, skilled nursing facility, rehabilitation facility, or nursing home housing the veteran.

3.3 Contractors shall have storage facilities physically located in the geographic area of the VA Medical Center, in which they shall provide service.

3.4 VA San Francisco Health Care System (VASFHCS) serves the counties of: Del Norte, Humboldt, Lake, Marin, Mendocino, Napa, San Francisco, San Mateo and Sonoma, California. The main VA facility is in San Francisco

4. PRICING

4.1 The Offeror shall price each CLIN inclusive of all transportation, fuel cost, tolls, labor, storage, training instruction, supervision and any other required element to carry out the performance work statement. The Offeror shall ensure that its price is inclusive of mileage/fuel and tolls within 50 miles as defined in paragraph 4.3. There are no ranges, sections, separations, etc. of locations as it relates to mileage/fuel/tolls charges and/or pricing.

4.2 The Offeror Contractor shall provide to the VA a quote using the Medicare allowable rates for patients in the facilities in paragraph 3.4.

4.3 The VA Health Care System is responsible for payment of mileage for only one-way in excess of 50 miles from the VA Medical Center (VAMC) or the closest warehouse. Mileage reimbursement will be calculated from the site (VAMC or warehouse) that is the shorter distance. No round-trip mileage will be reimbursed. The one- way charges apply to the distance where the request is complete; e.g. for a delivery, the mileage to the patient’s home but not the return trip; and for pick-up, the distance from the patient’s home to the vendor location and not the initial drive to get to the patient’s home. The Mileage will be calculated using the distances provided by MapQuest or equivalent software. The reimbursement rate will be the GSA contract rate for Privately Owned Vehicle Mileage-www.gsa.gov. When multiple jobs are consolidated, Mapquest route sheets with waypoints must be submitted for mileage reimbursements.

5. STORAGE FACILITY (DME)

5.1 Contractor shall provide clean, pest/rodent free, secure, contained area(s), with adequate space, for the storage of government owned DME and supplies covered under this contract. Contractors may have multiple warehouses physically located throughout the geographic area of the VA Medical Center, in which they shall provide service. The storage area shall be climate controlled throughout the year, and proper temperature and humidity shall be maintained. A temperature range of between 50 degrees Fahrenheit and 80 degrees Fahrenheit shall always be maintained and documented daily. Storage units or storage containers (such as PODS) will not be an acceptable means of storing government owned equipment. DME shall be stored on a rack 12” off the floor and 18” from the ceiling. Storage area(s) must conform to all applicable State, Local and National Fire Protection Association (NFPA) codes.