Q and A for RFQ 36C26224Q0353.pdf

Questions and Answers for RFQ 36C26224Q0353 – VA San Diego Medical Gases Requirement

1. Item 2, Scope: Delivery days of Tuesday and Thursday - 7am -11am. What is the reasoning for the 4 hour window and can this be adjusted? 7 am is technically prior to being open for regular business?

Answer: We provide deliveries to internal customers after 1200, this is required only at the San Diego Healthcare Medical Center Location. All other OPCs can be between 7AM – 3PM.

2. The VA is using both customer-owned and contractor-owned cylinders. 1) What is the plan for determining/identifying which cylinders are government owned and which are contractor owned, as we prefer to separate Ship-To Accounts. 2) Will the VA accept only contractor owned?

Answer: All cylinders are currently Contractor owned.

3. Contract shall furnish all materials needed to complete the job. We would like to clarify that the VA may need to purchase carts/racks and any other equipment for the cylinders. We supply only the gas/cylinders.

Answer: VA owns internal material handling and O2 cylinder carts. Cylinders are only needed to be delivered and picked up from Material Management cylinder cage next to loading dock and in the hallway marked “Empty Cylinders” behind Receiving Office B176. VAMCSD will distribute from there.

4. 2-hour response time - we cannot commit to this small of a window, we may be able to respond with a live person on the phone in 2 hours but not an actual delivery in 2 hours.

Answer: 2-Hour response time refers to confirmation of notification for emergent delivery.

Delivery window is 4 hours from time of confirmation.

5. Item 4: Is electronic invoicing allowed?

Answer: Electronic invoicing is allowed.

6. Item 8: Please clarify that supplier is not responsible for managing the VA's par levels at their hospital.

Answer: Par levels are maintained by simply providing a one for one exchange.

7. Is the contract required to deliver the Nitrous Oxide, Medical 50lbs tanks to the secure facilities location or are they to be delivered to the main gas cage?

Answer: Nitrous Oxide is to be delivered to the main Gas Cage.

8. For each location: San Diego Healthcare Medical Center, Kearny Mesa, Chula Vista, Oceanside, Sorrento Valley, and Escondido; will the contractor be required to travel to the service’s inside location to pickup and refill the N2 dewar or will the service bring the dewar to the main dock to be refilled?

Answer: OPCs are small centers with a dedicated inside area for N2 and no loading dock.

Contractor will pick up and refill from those inside areas.

9. CLIN clarification – Can the GOV please provide clarification regarding the following CLINs:

* CLIN 0003: What is the cylinder size? Answer: 24 cu ft E-tank

* CLIN 0004: What is the cylinder size? Answer: 6.6 lb E tank

* CLIN 0006: What is the cylinder size? Answer: 519 cu ft

* CLIN 0010: What is the cylinder size? Answer: 6.6 lb E tank

* CLIN 0014: Can a steel Tank be substituted for Aluminum? H-Tanks are not manufactured in Aluminum. Answer: Steel Tanks can be substituted.

* CLIN 0018: What is the cylinder size? Answer: H Tank. 50lb

* CLIN 0020: What is the gas in size Q? Answer: Nitrogen

* CLIN 0021: What is the cylinder size? Answer: This is for Siphon of Grab n Go Oxygen Tanks.

* CLINs 0022 – 0024: Confirm that this is supposed to be priced by the full fill as the Unit listed is Liter and doesn’t match? For example, CLIN 022 is for a 10 Liter N2 Dewar refill, yet the QTY/Unit listed is (2) Liters.

Answer: Answer: Qty is per tank/ea. Tank size is listed in Line Item description.

CLIN 00022-N2, liquid, Refill, 10 Liter 2 CLIN 00023-N2, liquid, Refill, 20 Liter 200 CLIN 00024-N2, liquid, Refill, 25 Liter 55

* CLIN 0025, Delivery: What is the Unit for this CLIN (possibly group)? Delivery Fees are typically “Each” which would be consistent with CLIN 0031 (Emergent Delivery).

Answer: Unit is EA (Each).

* Is there a reason why CLINs 0020 & 0021 have a Unit of “EA” while all other Gas Fill CLINs are “CY?” Also the Industry Standard for Cylinder Rental CLINs (0026 – 0030) is “CY” as they represent a QTY of Cylinders.

Answer: All units of measure are each. EA is considered, by the VAMCSD to be one full fill of a sized cylinder or one month of rental per EA cylinder.

10. What are the hours of operations that an Emergency Delivery can be made for a

VAMC/CBOC?

Answer: The hours of operations that an Emergency Delivery can be made are from 7AM – 3PM.

11. One-for-one cylinder exchange: What is the rationale for this procedure as it is highly irregular (not the VA procedures at VAMCs nationally as there is no requirement for the GOV to, via an authorized ordering officer, receive, and reconcile/account for Cylinders during the ordering, receiving, and reconciliation processes) and nonpractical, inefficient - given the common industry “best practices” elaborated on below (see bullets below)?

Answer: The Government does not see this as highly irregular to this facility. This is the operation to make it possible and feasible to facilitate the numerous services we provide for Veterans on a day-to-day basis. Gas is being provided to a 24hr facility.

12. The RFQ procedure “goes against” industry “Best Practice” and isn’t in place (to RAS knowledge) in any of our Medical Cylinder Contracts Nation Wide? As a practical matter, “mixed gases” are not commonly stocked due to preparation requirements, nor is it practical to require delivery trucks to always be stocked twice weekly, with these gases in expectation that the facility will have empty specialty gases that are used in specific locations within the hospital. Additionally, Ultra High Purity Argon with 6K PSI (CLIN 0001) is not a commonly stocked gas either.

This begs our question(s): What is the GOV’s rationale for expecting the SDVOB Prime Contractor, the responsible entity, to source orders, efficiently respond to any delivery issue, emergency orders, when the RFQ circumvents the ordering process (Ordering Officer authorized/initiated/submitted) within the Medical Cylinder Supply chain delivery process?

Answer: The Government is currently receiving this supply in accordance with identified procedures.

13. PG 6 of 84, Section 3. Response and Delivery Times, states that “Deliveries made on a Non- Emergent basis will be within 24 hours from time of notification” which infers gases being ordered proactively (industry standard for VAMCs). This conflicts with the SOW? In sum, the 24 Hour requirement is applicable to authorized Emergency Deliveries Nationwide (very large contracts such as our VISN 9 & 10 recent re-award – (19) high volume VAMCs).

Answer: Page 6 of 84 refers to missed deliveries.

14. For CBOCs, is the RFQ requiring that the Contractor make stops at each CBOC every TUE & THUR regardless if any gases are needed without prior notification (as well as the one-for-one cylinder exchange)? This is not reasonable, cost effective to the vendor (to give the GOV the best prices available), nor efficient. Please note, distribution is the highest cost in the gas supply industry and requiring this will greatly increase overall costs which in turn would significantly influence the “PRICE ONLY” Award evaluation - given that the RFQ currently states that evaluation is Price Only.

Answer: SOW language has been updated to include a process for providing estimated gas requirements at VA San Diego and outlaying CBOCs.

15. How does the GOV intend to validate Proof of Deliveries (PODs)? PODs are the delivery/accountability document that annotates/documents Cylinders delivered, and Cylinders returned for each delivery? In sum, how does the offeror document what types of gases and inclusivie quantities being billed if there is no “back up document” qualifying/quantifying billing if PODs are not recorded/signed by the VA Representative/Receiving Personnel at the time of delivery (“Best Practice” Nationwide/mandated by Facility as is Bulk Oxygen). This matter is “made worse” by no formal order being placed to commit GOV Funds - which is finalized by being signed by / validated by an Ordering officer and then VA Receiving Personnel when delivered. How does the VA intend to enforce Limitations on Subcontracting if there is no communication or ordering process taking place between the VA & SDVOB Prime Contractor?

Answer: Proof of delivery is accomplished by POCs at each location signing/verifying for deliveries and submitting invoices to the Ordering Officer John Quinn, also stated in the SOW on POC line under Delivery Locations.

16. While the SOW does require a bill of laden, PG 4 of 84 also states that the contractor or subcontractor is responsible for “…securing tanks with chains and ensuring the collection areas area locked or secured when they leave” which strongly infers that VA Receiving Personnel are not even present during the delivery process? In practical terms, this means meeting the driver upon delivery and providing escorted access by unlocking cylinder storage areas. It is the responsibility of the VA Personnel to ensure their cylinder storage areas are secure per NFPA regulations, not a delivery driver (high liability risk). Pointedly, when are VA personnel interacting with the Delivery Driver and are VA Personnel required to sign the delivery slip validating what is delivered/returned and provide access to the Government managed storage areas?

Answer: Proof of Delivery is accomplished by drivers and designated POCs at each facility signing for verified receipts. Providing the receipts are required by the contractor.

17. Please note, Proof of Delivery tickets are critical information items for accurate inventory management and invoicing but aren’t immediately available after delivery (typically available digitally a week after order completion).

Answer: SOW updated to include a proof of delivery procedure in Section 2.

18. In relation to question 1 - (7) of (24) Gas Fill CLINs provide incomplete descriptions which if not clarified offerors wouldn’t even know what to stock.

Please confirm that regular deliveries are strictly on TUE & THUR as there is a contradiction between PGs 7-8 of 84 in the RFQ?

Answer: Regular deliveries yes. Missed deliveries will be accepted anytime.

19. PG 6 states that Non-Emergent Deliveries will be made within 24 hours “after notification” yet PG 8 states that deliveries are TUE & THUR; The contradiction is that if any order placed on a Friday would not be delivered until TUE (more than 24 hours)

Answer: 24 hours means the next day and would be accepted anytime by on-call staff acting as POCs. This facility is operated on a 24-hour basis.

Is the current provider making all deliveries between 7 AM – 11 AM or is this a new requirement? This again is nonstandard and requiring this tight delivery window in a major metropolitan area will cause costs to rise exponentially. What is the rationale for a (4) hour delivery window rather than industry standard of 7 AM – 3 PM or similar 8-hour delivery window?

Answer: Yes, as deliveries to internal customers happen after 1200, however this is required only at the San Diego Healthcare Medical Center Location. All other CBOCs can be between 7AM

– 3PM.

20. Licensing: There is no mention of a requirement of the Prime Contractor to be licensed in the State of California (with the Board of Pharmacy) to resell/distribute Medical Grade Oxygen (a prescription drug). Please confirm that offerors (if out of state) must hold and maintain OUT OF STATE WHOLESALE DISTRIBUTION LICENSES for the State of CA (if in state, a CA Distribution License) – in sum, the prime contractor licensed in the State of California to resell/distribute Medical Grade Gas at the time of the Proposal Submission?

Answer: Contractor will adhere to all local, state, and federal regulations involving compressed gases.

21. NOTE: The State of California Board of Pharmacy requires for SDVOSB firms to be licensed in the State of California to resell Medical Grade Oxygen for human consumption (an FDA classified prescription drug). The SDVOSB firm cannot rely on the Subcontractor License as the Prime Contractor is the contract holder. In the event anything happens (e.g., Gas Contamination), the direct responsibility lies on the Prime Contractor and not the sub. This is even more pertinent when taking into consideration VAAR 852.219-76 Certificate of Compliance for Supplies & Products (PG 42-44 of 84 in the RFQ), which requires the offeror to affirm in writing that they take ownership/possession of the product and will perform 50% of the contract costs billed.

Would the VA want the only unlicensed entity in the Pharmaceutical Supply Chain to be the Prime Contractor?

Answer: VAAR 852.219-76 applies to this RFQ.

22. How does the GOV intend to enforce Limitations of Subcontracting in accordance with VAAR 852.219-76 (Certificate of Compliance - per PG 42-44 of 84 in the RFQ)? Additionally, the Certificate of Compliance requires the offeror to affirm that they take “possession or responsibility of the item,” which requires licensing in the state of CA (Prime Contractor taking responsibility for delivery of the prescription drug, regardless of what entity is physically delivering it to the Hospital). Furthermore, VISN 21 has a documented record of requiring the prime Contractor to be licensed in the State of CA (we can provide documentation if needed).

Answer: VAAR 852.219-76 applies to this RFQ. Vendors are responsible for ensuring adherence.

23. Loss of Use: What are the procedures to account for Loss of Use costs for Contractor owned Cylinders lost while in the GOV’s possession, documented/billed at the end of the contract?

Answer: Lost or Damaged Contractor-Owned Cylinders language has been added into the SOW as Section 3.1.

24. Will the GOV add Loss of Use CLINs or language so that offerors can be assured this will be covered/addressed?

Answer: Lost or Damaged Contractor-Owned Cylinders language has been added into the SOW as Section 3.1

25. There is a contradiction in that PG 4 of 84 states that Emergency Deliveries must be made within

(2) hours to either VAMC/OPC yet PG 6 of 84 states that they must be responded to within (2) hours and delivered within (4) hours. Is this being provided by the current supplier or is this a new requirement (Emergency Deliveries within 4 hours)? NOTE, no vendor can provide Emergency Deliveries within 2 or 4 hours, it cannot physically be done. It can be done “same day” with direct coordination between the COR and the Awardee. This is standard practice to ensure a procedure is not cancelled the next day due to lack of Medical Gas (again the GOV’s responsibility to order this, even if an emergency order, and this highlights the inherent inefficiencies of the current ordering process in the RFQ SOW). Furthermore, there is no reasonable means for the vendor to predict an emergency need, and if a valid emergency (authorized by the COR/ordering officer) – the SOW has no instructions on how an Emergency Order is initiated/processed/delivered/received. We would like to highlight that a GOV representative must be available “after hours” to receive the Emergency Ordered items (NOTE an Emergency Delivery incurs an additional charge).

Answer: Answer: SOW revised to read. Response and Delivery Times:

5.1 Missed Deliveries:

(a) Missed Delivery Reported by Contractor/Subcontractor Notification – Any missed delivery will be reported by Contractor to VAMCSD within 24 hours.

(b) Missed Delivery Reported by VAMCSD to Contractor Delivery –Missed deliveries reported by VAMCSD to Contractor will be delivered within 24 hours from time of notification.

5.2 Emergent Response – An Emergency request for gases will be responded to within 2 hours. Stating the time and location of expected delivery.

5.3 Emergent Deliveries - Deliveries made on an Emergent basis will be within 4 hours from time of Contractor response.

Restated, the response times are nonstandard, and furthermore, not attainable. We know of no supplier that can make Emergency Delivery within (4) hours after notification in a major metropolitan area. Drivers are on pre-established dispatched routes for healthcare customers and normally must return to the fill plant to secure Emergency Gases to then deliver to the VA facility. Standard Language for Emergency Delivery is within (24) hours which often includes after-hours deliveries in which the VA will have to provide a representative to receive the delivery. Will the GOV please amend this language to “within (24) hours” or must be able to respond within (4) hours?

Answer: Some gases are critical lifesaving. Timeframes will stay. This service is currently being provided.

26. Does the VAMC have any GOV Owned Cylinders? If so, how many by Size/Type?

Answer: The VAMC does not have any GOV owned Cylinders.

27. What is the projected Award Date and does the Period of Performance include phase-in/phase-out transition between contracts? NOTE: Even if the SDVOB Awardee hires the current subcontractor, a closeout cylinder audit must be conducted for the previous contract (between VA & Outgoing Contractor) which will identify Loss of Use Quantities. Only after the audit has been completed can cylinder balances be transferred to the new Prime SDVOB accounts which tend to take the longest to schedule during the transitional period between Incoming/Outgoing Contractor.

Answer: Language added to updated SOW to clarify:

4. Installation of Non-Government Owned Equipment

4.1 Unless otherwise directed by the using facility, contractor owned equipment shall be installed by the effective date of the contract no exceptions; provided: If the contractor’s equipment replaces equipment already in use, the contractor shall be allowed a maximum of ninety days after receipt of notice of award to complete installation. the exchange of equipment shall be accomplished without interruption of gas supply to the using facility.

4.2 If Contractor subcontracts to vendor currently servicing facility and no exchange of equipment applies, it will be the sole responsibility of the Contractor to inventory such equipment. Contractor/subcontractor installed equipment shall remain the property of the contractor/subcontractor and shall be removed upon termination of the contract, when directed by the ordering facility and in full cooperation with the succeeding contractor so as to avoid interruption of gas supply.

4.3 To permit orderly transition from one contractor to another, the contractor shall continue to honor the contract’s monthly equipment rental fee and Medical Gases contract price for a maximum of ninety days beyond the scheduled expiration of the contract period, unless transition from one contractor to another is completed prior to the ninety-day transition period.

For any partial month, the contractor shall prorate the monthly equipment rental fee accordingly. The contractor shall continue to provide and maintain its equipment during this transition period.

4.4 No guarantee is given or implied that data included in the Schedule of Supplies and Services regarding contractor owned equipment currently located at the facilities is complete and accurate as to the factors affecting the cost of furnishing and installing the required contractor owned tanks and appurtenances. Offerors are strongly encouraged to visit the facility site prior to submitting a quote and take other steps as may be reasonably necessary to ascertain the nature and location of the work, and the general and local conditions which can affect the work or the cost thereof. Failure to do so shall not relieve offerors from the responsibility of estimating properly the difficulty and cost of successfully performing the work. Site visits may be arranged by contacting the COR designated in the solicitation Schedule of Supplies and Services.

28. Billing/Invoicing (PG 6 of 84): Will the GOV clarify if each facility is to get its own funding document to invoice against or will it utilize one funding document for all locations? If one funding document, will the GOV consider one consolidated monthly invoice to include all locations (annotated separately)? “Contractor will send usage report to the technical POC or CONTRACTING OFFICER REPRESENTATIVE on a Monthly basis on all gases purchased with the exact amount purchased and Cylinder Rental charges “BY LOCATION’ to VAMCSD. Invoicing WILL be “SEPERATED BY LOCATION” and ANNOTATED ON ALL INVOICES SUB OR PRIME. All Invoices WILL CLEARLY STATE THE CLIN (CONTRACT LINE ITEM), TYPE, AND QUANTITY OF GAS EXACTLY

AS STATED ON THE CONTRACT.”

Answer: This award will have one funding document. Consolidated Invoices are acceptable.

Contractor is expected to itemize location and specific CLIN.

29. Additionally, PG 4 of 84 states “The contractor will also provide a monthly consolidated invoice clearly showing each line item and amount of each line item delivered for that month no later than the Monday of the first working week of the following month.” Proof of delivery slips, which are pertinent to the monthly invoicing, are commonly not available for a week. If the final delivery of the month is on a THUR, there’s no way the Prime SDVOB can have the consolidated Monthly invoice submitted in only (2) business days. Will the GOV expand this deadline to “within (7) days after the end of the monthly billing period?

Answer: Invoice submission timeline has been changed to 7 days after the end of the monthly billing period.

30. Liability Insurance: There is no mention of any Liability Insurance requirement of the Prime Contractor, which is a standard requirement for these types of medical gas service contracts (NAICS 325120/221210). Please confirm that the Prime Contractor must hold Liability Insurance specific to 325120? How is the GOV Evaluation Committee going to discern that offerors are insured for NAICS 325120 -- the actual requirement for this work to comply with the RFQ?

Answer: Contractor will adhere to all local, state, and federal regulations involving compressed gases.

31. Is the “Mission Valley” OPC (mentioned on PG 4 of 84) the same as the Kearny Mesa OPC (listed on PG 5 of 84)? Kearny Mesa is not in Mission Valley but there is a Rio VA Clinic in the HCS that resides in Mission Valley. Please confirm.

Answer: Kearny Mesa replaced Mission Valley.

32. What are the gas-specific requirements for each Outpatient Clinic by gas (CLIN/size/type) & annual usage quantity by gas respective to each clinic? Typically, CBOCs require Liquid Nitrogen & Integrated Valve Oxygen E Cylinders.

1. Kearny Mesa

2. Chula Vista

3. Oceanside

4. Sorrento Valley

5. Escondido

Answer: These gases are on an as needed per procedure basis. Quantities listed are for total yearly usage. Gases at CBOCs are low usage and require one for one exchange.

33. Does the delivery schedule of between the hours of 7AM – 11AM Tuesday and Thursday apply only to the VAMC or to all (6) Facilities? Typically, a facility of this size that needs 2x a week will have deliveries MON/THUR or TUE/FRI to allow deliveries closer to the weekend for preparation purposes.

Answer: Only VASDMC All others will be Monday through Friday 7am to 3pm. Clarification provided on updated SOW.

34. Is the current supplier making deliveries in this 4-hour delivery window? This is nonstandard especially in a major metropolitan are such as San Diego.

Answer: Yes.

35. What is the rationale for making Price the only Evaluation Factor, for awarding something as critical as Medical Grade Oxygen, a Prescription Drug? Why are bidding vendors not required to submit a statement of technical capability (to include Past Performance & Licensing/proper Insurance - which is a requirement by the CA Board Pharmacy)?

Answer: Technical Capability is added as an Evaluation factor to include licensing and insurance requirements.

36. Making Recent and Relevant Past Performance an Evaluated factor – as a predictive analysis for an offerors ability to perform/support this critical Hospital function? How would the GOV discern that a “lowest price” offer (other than the incumbent) has a history of successfully performing similar work?

Answer: Past performance data is reviewed for all successful awardees of federal government contracts.