36C26225Q0290 0001_1.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 02-19-2025 36C26225Q0290 36C262 Department of Veterans Affairs NCO 22 - Network Contracting 3601 S. 6th Avenue Tucson

AZ

85723 36C262 Department of Veterans Affairs NCO 22 - Network Contracting 3601 S. 6th Avenue Tucson

AZ

85723 To all Offerors/Bidders

36C26225Q0290

X X X See CONTINUATION Page X The purpose of this amendment is to update the HCPCS code on line items 0001AA, 1001AA, 2001AA, 3001AA, and 4001AA from (A0422) to (A0426).

This amendment also updates Section 5.2.3. of the PWS to only reflect the VA Medical Centers or Hospital located in CA as they pertain to this solicitation.

All offers due via email NLT February 20, 2025 @ 4:00 pm PST to:

Contract Specialist: Katharine Robert Email: katharine.robert@va.gov

CONTINUATION PAGE

ITEM INFORMATION

0001AA

(A0426) Advanced Life Support Non-Emergent Transport, Level 1 (ALS 1) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. (base rate to include first 40 miles) One-way trip is equivalent to one each for the unit of issue. Per trip. Estimated Quantities.

Contract Period: Base POP Begin: 03-11-2025 POP End: 03-10-2026 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

OPTION YEAR 1

1001AA

(A0426) Advanced Life Support Non-Emergent Transport, Level 1 (ALS 1) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. (base rate to include first 40 miles) One-way trip is equivalent to one each for the unit of issue. Per trip. Estimated Quantities.

Contract Period: Option 1 POP Begin: 03-11-2026 POP End: 03-10-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

OPTION YEAR 2

2001AA

(A0426) Advanced Life Support Non-Emergent Transport, Level 1 (ALS 1) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. (base rate to include first 40 miles) One-way trip is equivalent to one each for the unit of issue. Per trip. Estimated Quantities.

Contract Period: Option 2 POP Begin: 03-11-2027 POP End: 03-10-2028

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

OPTION YEAR 3

3001AA

(A0426) Advanced Life Support Non-Emergent Transport, Level 1 (ALS 1) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. (base rate to include first 40 miles) One-way trip is equivalent to one each for the unit of issue. Per trip. Estimated Quantities.

Contract Period: Option 3 POP Begin: 03-11-2028 POP End: 03-10-2029

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

OPTION YEAR 4

4001AA

(A0426) Advanced Life Support Non-Emergent Transport, Level 1 (ALS 1) Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. (base rate to include first 40 miles) One-way trip is equivalent to one each for the unit of issue. Per trip. Estimated Quantities.

Contract Period: Option 4 POP Begin: 03-11-2029 POP End: 03-10-2030

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

5.2.3. Other VA Medical Centers or Hospitals within Veterans Integrated Service Network (VISN) 22 including but not limited to:

See attached document: RFQ 36C26225Q0290 GROUND AMBULANCE SERVICES_ALS_CCT updated.

See attached document: va10091.

See attached document: FORM W9.