36C26125Q0036 VANCHCS Ambulance RFQ.pdf
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- Attached to
- V225--VANCHCS Ambulance Services - Placer, Sacramento, San Joaquin, Yolo, Stanislaus, Shasta Counties
- Solicitation number
- 36C26125Q0036
About this file
This document is a Request for Quote (RFQ) for Ground Ambulance Services to support the Sacramento VA Medical Center and its associated Community-Based Outpatient Clinics. The contractor shall provide Urgent, Non-urgent Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) services on an as-needed basis in Placer, Contra Costa, Sacramento, San Joaquin, Yolo, Stanislaus, and Shasta Counties. The contract has a five-year period of performance from 01/31/2025 to 01/30/2030 with a guaranteed minimum award of $2,500 and a maximum aggregate value of $5,000,000. The solicitation is unrestricted, but includes set-asides for small business, HUBZone, service-disabled veteran-owned, and women-owned small businesses. Questions are due by 12/04/2024, and quotes shall be submitted by email. The Performance Work Statement details the contractor's responsibilities for personnel, equipment, vehicles, transportation requests, patient welfare, and invoicing.
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PAGE 1 OF 1. REQUISITION NO.
2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER
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
36C26125Q0036
6. SOLICITATION ISSUE DATE
11-19-2024
Joshua Barrios, joshua.barrios@va.gov 916-923-4559 12-13-2024
12:00 PM PST
612MCP
Department of Veterans Affairs
Network Contracting Office (NCO) 21
3237 Peacekeeper Way, Bldg 200 Suite 204
McClellan Park CA 95652
X
621910
$22.5 Million
N/A
X
Please reference the Performance Work
Statement (PWS).
612MCP
Department of Veterans Affairs
Network Contracting Office (NCO) 21
3237 Peacekeeper Way, Bldg 200 Suite 204
McClellan CA 95652
Department of Veterans Affairs
FMS VA-9(101) Financial Services Center
PO Box 149971
Austin TX 78714-9971
See CONTINUATION Page
This is a Request for Quote to provide Ground Ambulance
Services in accordance with the Performance Work Statement
(PWS) contained herein.
Please refer to the Addendum to FAR 52.212-1, Instructions to Offerors, and VAAR 852.273-73 for details on how to respond.
Questions regarding this Request for Quote (RFQ) are due
12/04/2024 by 12:00 pm PST.
Questions and quotes shall be submitted by email only to joshua.barrios@va.gov.
See CONTINUATION Page
X X
X 1
Emily Trinh
Contracting Officer
36C26125Q0036
Table of Contents
SECTION A
A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS
AND COMMERCIAL SERVICES
SECTION B - CONTINUATION OF SF 1449 BLOCKS
B.1 CONTRACT ADMINISTRATION DATA
B.2 PRICE/COST SCHEDULE
ITEM INFORMATION
B.3 PERFORMANCE WORK STATEMENT
B.4 VA INFORMATION AND INFORMATION SYSTEM SECURITY AND PRIVACY
LANGUAGE FOR INCLUSION IN CONTRACTS, AS APPROPRIATE
SECTION C - CONTRACT CLAUSES
C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
C.2 SUPPLEMENTAL INSURANCE REQUIREMENTS
C.3 52.216-18 ORDERING (AUG 2020)
C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)
C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)
C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)
C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR
1984)
C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)
C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)
C.10 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR
PERSONNEL (MAY 2020)
C.11 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA
BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)
C.12 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-
OWNED SMALL BUSINESS EVALUATION FACTORS (JAN 2023) (DEVIATION)
C.13 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)
C.14 VAAR 852.219-70 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM
REQUIREMENTS (NOV 2022)
C.15 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)
C.16 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS
(NOV 2018)
C.17 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE
(OCT 2019)
C.18 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)
C.19 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 82
C.20 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT
STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND
COMMERCIAL SERVICES (MAY 2024)
SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS
SECTION E - SOLICITATION PROVISIONS
E.1 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)
E.2 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL
ITEMS
E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB
1998)
E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS
AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)
E.5 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT
ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)
E.6 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)
E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)
E.8 VAAR 852.215-72 NOTICE OF INTENT TO RE-SOLICIT (OCT 2019)
E.9 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION
(OCT 2018)
E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)
E.11 VAAR 852.273-70 LATE OFFERS (NOV 2021)
E.12 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (JAN 2003) . 102
E.13 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)
E.14 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—
COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024)
SECTION B - CONTINUATION OF SF 1449 BLOCKS
B.1 CONTRACT ADMINISTRATION DATA
(continuation from Standard Form 1449, block 18A.)
1. Contract Administration: All contract administration matters will be handled by the following individuals:
a. CONTRACTOR: TBD
b. GOVERNMENT: Contracting Officer
Department of Veterans Affairs
Network Contracting Office (NCO 21)
2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:
[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management
[ ] 52.232-36, Payment by Third Party
3. INVOICES: Invoices shall be submitted in arrears:
a. Quarterly [ ]
b. Semi-Annually [ ]
c. Other [X] Monthly in accordance with issued task orders
4. GOVERNMENT INVOICE ADDRESS: Invoices will be electronically submitted to the Tungsten website at http://www.tungsten-network.com/US/en/veterans-affairs/. Tungsten direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “Instructions for invoice entry” within Useful information & downloads on the Tungsten Website. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice. Clarif ication of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. 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 questions about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:
http://www.tungsten-network.com/US/en/veterans-affairs/
Tungsten Support
Phone: 1-877-489-6135
Website: http://www.tungsten-network.com/US/en/veterans-affairs/
Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com
Department of Veterans Affairs Financial Service Center
Phone: 1-877-353-9791 Email: vafsccshd@va.gov
More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp
5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
AMENDMENT NO. DATE
http://www.tungsten-network.com/US/en/veterans-affairs/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov http://www.fsc.va.gov/einvoice.asp
B.2 PRICE/COST SCHEDULE
Contractor shall provide Ground Ambulance Services in accordance with the Performance Work
Statements Contained herein. Quantities are considered estimated.
The guaranteed minimum award amount for this contract is $2,500.00. The maximum aggregate value of orders that can be placed under this contract is $5,000,000.00. The Government does not guarantee that it will place any orders under this contract more than the guaranteed minimum award amount.
Period of Performance: 01/31/2025 – 01/30/2030
ITEM INFORMATION
ITEM
NUMBER
DESCRIPTION OF
SUPPLIES/SERVICES
ESTIMATED
QUANTITY UNIT UNIT PRICE AMOUNT
35.00 EA __________________ __________________
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Base Placer
County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation -
Travel/Lodging/Recruitment: Ambulance
50.00 EA __________________ __________________
Basic Life Support, Non-Emergency Transport, Base Placer County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
1,975.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (ALS or BLS Mileage Placer County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
24.00 EA __________________ __________________
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
9.00 EA __________________ __________________
Critical Care Transport (Upper-Level Care) Base Contra Costa County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
1,000.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (BLS or CCT Mileage Contra Costa
County)
Contract Period: Ordering Period 1 POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Base
Sacramento County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
12.00 EA __________________ __________________
Basic Life Support, Non-Emergency Transport, Base Sacramento County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
800.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (ALS or BLS Mileage Sacramento
County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Base San
Joaquin County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Basic Life Support, Non-Emergency Transport, Base San Joaquin County
(base rate, to include first 40 miles)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025 POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
6.00 EA __________________ __________________
Critical Care Transport (Upper-Level Care) Base San Joaquin County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
1,500.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (ALS, BLS, or CCT Mileage San Joaquin County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
4.00 EA __________________ __________________
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Base Yolo
County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
25.00 EA __________________ __________________
Basic Life Support, Non-Emergency Transport, Base Yolo County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
2.00 EA __________________ __________________
Critical Care Transport (Upper-Level Care) Base Yolo County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
2,050.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (ALS Yolo County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
1,300.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (BLS Yolo County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
1,700.00 EA __________________ __________________
Mileage Trip Outside the Base Rate (CCT Yolo County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Stanislaus County Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
Basic Life Support, Non-Emergency Transport, Base Stanislaus County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Critical Care Transport (Upper-Level Care) Base Stanislaus County
Contract Period: Ordering Period 1 POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mileage Trip Outside the Base Rate (ALS, BLS, or CCT Mileage Stanislaus
County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Basic Life Support, Non-Emergency Transport, Base Shasta County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mileage Trip Outside the Base Rate (ALS or BLS Mileage Shasta County)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Basic Life Support, Non-Emergency Transport, Base Redding
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
7.00 EA __________________ __________________
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Redding to
Shasta Regional County
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Basic Life Support, Non-Emergency Transport, Base Redding CBOC to
Mather VAMC Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
0.00 EA __________________ __________________
Wait Time (15 Minute Interval IAW 4.9.1 of the PWS)
Contract Period: Ordering Period 1
POP Begin: 01-31-2025
POP End: 01-30-2026
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 2 POP Begin: 01-31-2026
POP End: 01-30-2027
Sacramento County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2 POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
(base rate, to include first 40 miles)
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Basic Life Support, Non-Emergency Transport, Base Yolo County Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Stanislaus County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026 POP End: 01-30-2027
County)
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta County Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Advanced Life Support, Emergency Transport, Level 1 (ALS 1) Redding to
Shasta Regional County
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mather VAMC
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 2
POP Begin: 01-31-2026
POP End: 01-30-2027
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Sacramento County
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027 POP End: 01-30-2028
County)
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
(base rate, to include first 40 miles)
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3 POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Stanislaus County
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta County
Contract Period: Ordering Period 3 POP Begin: 01-31-2027
POP End: 01-30-2028
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027 POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta Regional County
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mather VAMC
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Wait Time (15 Minute Interval IAW 4.9.1 of the PWS)
Contract Period: Ordering Period 3
POP Begin: 01-31-2027
POP End: 01-30-2028
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028 POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
County)
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Sacramento County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028 POP End: 01-30-2029
(base rate, to include first 40 miles)
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4 POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028 POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Stanislaus County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta County
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028 POP End: 01-30-2029
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta Regional County
Contract Period: Ordering Period 4 POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mather VAMC
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 4
POP Begin: 01-31-2028
POP End: 01-30-2029
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029 POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Sacramento County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Joaquin County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
(base rate, to include first 40 miles)
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
Joaquin County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mileage Trip Outside the Base Rate (BLS Yolo County)
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Stanislaus County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029 POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
County)
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Shasta Regional County
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Mather VAMC
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030
PRINCIPAL NAICS CODE: 621910 - Ambulance Services
Contract Period: Ordering Period 5
POP Begin: 01-31-2029
POP End: 01-30-2030 PRINCIPAL NAICS CODE: 621910 - Ambulance Services
GRAND TOTAL __________________
B.3 PERFORMANCE WORK STATEMENT
1. Purpose: The Sacramento VAMC VA Medical Center (hereafter Sacramento VAMC), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Stretcher Transports, Basic Life Support (BLS), Advanced Life Support
(ALS), Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as needed, 24 hours a day, seven days a week (24/7), including weekends and holidays.
2. Background: The (Sacramento VAMC) main campus is located 10535 Hospital Way, Mather, CA, serving over 140,000 veterans, primarily from the greater Sacramento and San
Francisco Bay areas and it’s 11 Community-Based Outpatient Clinics. The hospital has 50 inpatient beds and sees approximately 4000 inpatient admissions and 550000 outpatient visits a year. Veterans served within this facility lives within the following counties and zip codes.
County/Zip Code
County/Zip Code
County/Zip Code
County/Zip Code
County/Zip Code
Shasta County Tehama El Dorado
Placer County Tuolumne Sutter Sacramento Stanislaus Yolo
Butte San Joaquin Yuba Colusa Trinity Contra Costa
Glenn Solano Siskiyou Amador
3. Acronyms
ALS – Advanced Life Support
AOD – Administrative Officers of the Day
BLS – Basic Life Support
CCT – Critical Care Transport
CCTP – Critical Care Transport Paramedic
CCEMTP – Critical Care Emergency Medical Transport
CO – Contracting Officer
COR – Contracting Officer’s Representative
CPR – Cardiopulmonary Resuscitation
DOL – Department of Labor
EMT – Emergency Medical Technician
IAW – In Accordance With
OO – Ordering Officer
PWS – Performance Work Statement
QASP – Quality Assurance Surveillance Plan
QC – Quality Control Plan
TB – Tuberculosis
TJC – The Joint Commission
VTS – Veteran Transportation Service
4. Scope/Requirements
4.1. Types of Ambulance Service
4.1.1. The contractor shall provide Urgent, Non-urgent Stretcher Transports, Basic Life
Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT)
Tier 1, 2, and 3 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.
4.1.1.1. Tier 1: A time critical case with a lights and sirens ambulance response. An example is a cardiac arrest or serious traffic accident.
4.1.1.2. Tier 2: An acute but non-time critical response. The ambulance does not use lights and sirens to respond. An example of this response code is a broken leg.
4.1.1.3. Tier 3: A non-urgent routine case.
4.1.2. Occasionally a veteran will need to be transported with VA staff and equipment;
the contractor shall return VA Staff and equipment to the original place of pick-up.
4.2. Transport of Miscellaneous Items with the Patient
The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When VA-beneficiaries are transported to the Sacramento VAMC, destination is deemed to be the ER, Admissions, the clinic, or service within the hospital, or directly to the ward as instructed by VA Staff.
4.3. Contractor Personnel: Contractor personnel shall be courteous and always conduct themselves in a businesslike manner while providing services under this contract.
4.3.1. Emergency Medical Technicians (EMTs), Critical Care Transport Paramedics
(CCTPs) & Other Personnel
4.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualif ications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs and other medical personnel (as applicable) shall be certif ied, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.
4.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other qualif ications to the Contracting Officer’s Representative (COR) for review.
4.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform.
If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the COR.
4.3.1.4. CCTPs shall have met all state requirements for the tier in which they are performing services in (I, II, III). Proof in the form of a current certif icate for the successful completion of such must be provided to the COR upon request.
4.3.1.5. Investigative Requirements for Contract Personnel: Contract personnel will be subject to the same investigative requirements as those for regular VA appointees and employees. The level of investigation commensurate with the level of access to perform the performance work statement is: Special
Agreement Checks (SAC). Fingerprinting for contract personnel will be conducted at Sacramento VAMC. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirement as provided by (Sacramento VAMC). The VA
Security and Investigation Center (SIC) is responsible for adjudicating all background investigations for contract employees.
4.3.1.6. EMTs, CCTPs, and other contractor personnel as applicable must pass the
Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and
Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.
4.3.2. Tuberculosis Exposure Control Policy
4.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.
4.3.2.2. The contractor shall have its personnel tested for TB in accordance with state guidelines and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test by the start of each Ordering Period.
4.4. Contractor Equipment, Vehicles, and Inspection
4.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards.
4.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee 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 in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.
4.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.
4.4.4. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA. Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Contract Vendors are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.
4.4.5. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to Sacramento VAMC or its CBOCs within the area of responsibility.
4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Attachment A Critical Care Transport
Capabilities Confirmation. The contractor shall have the appropriate medications, up to and including CCT Tier III if necessary, based on the EMS region the ambulance provider is functioning in.
4.4.7. The contractor shall furnish qualif ied personnel as required by contract specifications to accomplish all services under this contract.
4.4.7.1. The contractor personnel performing services for the VA, shall, at all times, conduct themselves in a professional manner, and be identif ied by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, uniforms, nametags and/or badges for performance of services under this contract. Employee identif ications shall be worn in clear view above the waist.
The contractor personnel shall not smoke/play loud music originating from any device in vehicles while transporting VA-beneficiaries.
4.4.7.2. Each driver shall possess a driver’s license that is valid for the class of vehicle driven. Evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.
• Be at least 18 years of age and have not less than one year of experience as a licensed driver; and o For the past three years:
▪ Have not had a driver’s license canceled or suspended.
▪ Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance.
▪ Have a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven
▪ Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance.
4.4.7.3. The contractor personnel will ensure that the patient is secured to the stretcher/cot and that the stretcher /cot is secure in the back of the ambulance before the vehicle moves.
4.4.7.4. Ambulance drivers shall have a valid medical certif ication, in accordance with Federal, State, and local government requirements for their place of operation for the services they perform, be capable of administering oxygen and shall have successfully completed the standard and advanced first aid course of the American Red Cross of U.S. Bureaus of Mines of equivalent and be capable of providing necessary medical assistance to the attending emergency medical technician or paramedic.
4.4.7.5. Emergency Medical Technician (EMT) and Paramedic Qualif ications: EMT’s and Paramedic’s providing services under this contract shall have the following qualif ications, in additions to those required by Federal, State, and
Local Government:
• Have completed training in accordance with the standards published by the Department of Health and Human
Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304.
(1974).
• Shall be certif ied, licensed, or otherwise officially recognized by the local, state of regional government or public entity where the emergency ambulance service is operated or by which it is governed.
4.5. Transportation Request
4.5.1 VetRide or VA-Approved Transportation Software Utilization:
The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved
Transportation Software with every patient transported under this contract.
Department of Veteran Affairs will provide the software and access to the VetRide
Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved
Transportation Software fully as instructed:
a) Receive and respond to electronic trip requests
b) Receive, use, and ensure the use of the Vendor pass by the driver.
c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-
Approved Transportation Software system.
d) All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.
i. The contractor’s invoice must be on the HCFA 1500 to include:
ii. Contract Number
iii. Date of Service (to include Box 24 A-J)
iv. Authorization number(s)
v. Pick-up and drop-off location of the patient
vi. Base Rate
vii. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported
viii. Date of Birth and Sex
ix. Diagnosis Codes or Nature of Illness or Injury
x. Documentation of circumstances when billing for waiting time
xi. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.
xii. VA authorizing official’s name
xiii. Healthcare Procedure Coding System/National Level II (HCPCS)
e) Unauthorized charges will be reviewed by the Contracting Officer Representative
(COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the
Contractor of the charges, which are being suspended.
4.5.1.1. A transportation request is defined as one incidence of a request for one-way service (Stretcher Transports, BLS, ALS, CCT). No more than one patient will be transported per order unless approved by an authorized VA staff.
Transportation requests will be made through VetRide or VA-Approved
Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. (Sacramento VAMC) Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.
4.5.1.1.1. (Sacramento VAMC) Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.
4.5.1.1.2. The Contractor must update VetRide or VA-Approved
Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. (Sacramento VAMC) Travel Program Staff/or authorized
VA employees may place a “hold” on payment of this order until it has been reconciled.
4.5.1.2. Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:
Contracting Officer (CO) Ordering Officers (OO)
Administrative Officer of the Day (AOD) Beneficiary Travel Office
Staff
Contracting Officer’s Representative (COR)
The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as Ordering Officers change.
Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract.
The Contractor shall accept orders against this contract only from the
Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.
Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.
4.5.1.2.1. All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated Ordering Officers.
When placing orders for services, the Ordering Officer shall contact the designated contractor point of contact(s) to provide the following information:
▪ Mode of transportation required,
▪ Required time of arrival
▪ Name of the beneficiary,
▪ Pick-up and delivery point,
▪ Type and number of additional medical care specialists required,
▪ Type of equipment required,
▪ Last four of the patient's Social Security Number, and
▪ Any other special instructions
4.5.1.3. For ALL Transports – an Audit system will be put in place by the VA to include the COR or designee, Beneficiary Travel Department staff, and clinical staff to ensure appropriateness of the order and timeliness of the response.
4.5.1.4. The type of transportation service (Stretcher Transports, BLS, ALS, CCT) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.
4.5.1.5. The VA may authorize an escort (e.g., spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and, in the patient’s, best interest. The contractor shall allow the escort to accompany the patient at no additional cost.
4.5.1.6. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. Transports required may be for any mix of Stretcher Transports, BLS, ALS transports.
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