36C26319Q0368-002.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT 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. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 92

Included on task orders issued against IDIQ.

36C26319Q0368 04-29-2019

Doug Reed 605-336-3230 x 7844 05-20-2019

10:00am CST

Sioux Falls Services Team

Department of Veterans Affairs

Network Contract Office 23 (NCO 23)

2501 W. 22nd St.

Sioux Falls SD 57105

X

621910

$15 Million

N/A

Sioux Falls VA Health Care System

2501 West 22nd Street

Sioux Falls Services Team

Network Contract Office 23 (NCO 23)

2501 W. 22nd St.

Financial Services Center

Via The Tungsten Network

Refer to VAAR Clause 852.232.72

See CONTINUATION Page

Ground Ambulance Transport Services to support the Sioux

Falls VA Health Care System

This is a Full and Open, Unrestricted solicitation conducted using Federal Acquisition Regulation (FAR) Part 13

(Simplified Acquisition) procedures.

Please refer to Section B.2 for Price Schedule

Please refer to Section B.3 for Performance Work Statement

Please refer to Section E, FAR 52.212-1, for Instructions to

Offerors.

Please refer to Section E, FAR 52.212-2, for Evaluation

Factors

Offerors shall be active and registered at System for Award

Management (https://www.sam.gov) at time of offer to the

Government.

See CONTINUATION Page

To be cited on all task orders issued against awarded

Indefinite Delivery, Indefinite Quantity (IDIQ) Contract.

X X

X 1

Doug Reed

VA-VHA-SAOC-2016-AC23EC83

36C26319Q0368

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE SCHEDULE…………………………………………………………………………..6

B.3 PERFORMANCE WORK STATEMENT………………………………………………….10

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.216-18 ORDERING (OCT 1995)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) . 29

C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.8 52.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN 1997) 30

C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.10 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009)

C.11 VAAR 852.219-9 VA SMALL BUSINESS SUBCONTRACTING PLAN MINIMUM

REQUIREMENTS (DEC 2009)

C.12 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.13 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE

(JUL 2018)

C.14 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.16 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.17 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.18 NATIONAL ARCHIVES AND RECORDS ADMINISTRATION (NARA) RECORDS

MANAGEMENT LANGUAGE FOR CONTRACTS

C.19 IT CONTRACT SECURITY

C.20 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2019)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.4 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JUL 2016)(DEVIATION)

E.5 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.6 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) .. 74

E.7 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

E.8 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014) [TAILORED]

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (OCT 2018)

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: TBD

b. GOVERNMENT: Contracting Officer 36C263 Doug Reed, douglas.reed3@va.gov

Sioux Falls Services Team

Department of Veterans Affairs

Network Contract Office 23 (NCO 23)

2501 W. 22nd St.

Sioux Falls SD 57105

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, or [] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Weekly through Tungsten Network

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.

Department of Veterans Affairs

Financial Services Center

Via The Tungsten Network

Refer to VAAR Clause 852.232.72

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

AMENDMENT NO DATE

B.2 PRICE SCHEDULE

Contract guaranteed minimum is $20,000 for the base period of performance and will be awarded at time of contract award via the initial task order.

Contract maximum is $2,000,000 for lifetime of the contract.

Quantities listed are estimates only based on historical data. Actual quantities on task orders can be less than or greater than estimated quantities listed based on Sioux Falls VA Health Care System needs.

Only warranted Contracting Officers from Network Contracting Office (NCO) 23, Department of Veterans Affairs can issue task orders against this single award Indefinite Delivery, Indefinite Quantity (IDIQ) contract:

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES

ESTIMATED

QUANTITY UNIT UNIT PRICE

ESTIMATED

AMOUNT

351.00 TRP __________________ __________________

Cost Per Trip Within 20 Mile Radius; includes all costs for advanced life support

(ALS) transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only”.

Ordering Period 1: 07-01-2019 to 06-30-2020

409.00 TRP __________________ __________________

Cost Per Trip Beyond 20 Mile Radius; Includes all costs for advanced life support transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only” or the distance over which the patient is transported and includes “No Load” payment when the patient is not transported.

Ordering Period 1: 07-01-2019 to 06-30-2020

9,792.00 MI __________________ __________________

Cost Per Mile Beyond 20 Mile Radius. To be billed with corresponding CLINs

0002, 1002, 3002, and 4002.

Ordering Period 1: 07-01-2019 to 06-30-2019

1,340.00 EA __________________ __________________

Wait Time; Per quarter hour (15 minutes) beyond the initial 15 minutes. Does not include the reasonable amount of time to load/unload patients at the destination or departure location.

Ordering Period 1: 07-01-2019 to 06-30-2020

ORDERING PERIOD 1 ESTIMATED TOTAL (CLINS 0001 to 0004):

(ALS) transport, pick-up, oxygen, supplies and paramedic services. Payment limited

Ordering Period 2: 07-01-2020 to 06-30-2021 transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only” or the distance over which the patient is transported and includes include the reasonable amount of time to load/unload patients at the destination or departure location.

Ordering Period 2: 07-01-2020 to 06-30-2021

ORDERING PERIOD 2 ESTIMATED TOTAL (CLINS 1001 to 1004):

(ALS) transport, pick-up, oxygen, supplies and paramedic services. Payment limited

Ordering Period 3: 07-01-2021 to 06-30-2022 transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only” or the distance over which the patient is transported and includes include the reasonable amount of time to load/unload patients at the destination or departure location.

Ordering Period 3: 07-01-2021 to 06-30-2022

ORDERING PERIOD 3 ESTIMATED TOTAL (CLINS 2001 to 2004):

(ALS) transport, pick-up, oxygen, supplies and paramedic services. Payment limited

Ordering Period 4: 07-01-2022 to 06-30-2023 transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only” or the distance over which the patient is transported and includes include the reasonable amount of time to load/unload patients at the destination or departure location.

Ordering Period 4: 07-01-2022 to 06-30-2023

ORDERING PERIOD 4 ESTIMATED TOTAL (CLINS 3001 to 3004):

(ALS) transport, pick-up, oxygen, supplies and paramedic services. Payment limited

Ordering Period 5: 07-01-2023 to 06-30-2024 transport, pick-up, oxygen, supplies and paramedic services. Payment limited to “one way only” or the distance over which the patient is transported and includes

Ordering Period 5: 07-01-2022 to 06-30-2023

Ordering Period 5: 07-01-2023 to 06-30-2024 include the reasonable amount of time to load/unload patients at the destination or departure location.

Ordering Period 5: 07-01-2023 to 06-30-2024

ORDERING PERIOD 5 ESTIMATED TOTAL (CLINS 4001 to 4004):

ESTIMATED

GRAND TOTAL

(CLINS 0001 to 4004)

B.2 PERFORMANCE WORK STATEMENT (PWS)

DESCRIPTION OF SERVICE:

This is a contract for the provision of ambulance transport services. The Contractor shall pick up patients from designated locations and transport to designated location per direction of the Sioux Falls VA Health

Care System. The contractor shall furnish emergency and non-emergency ambulance service for the beneficiaries of the Department of Veterans Affairs Health Care System, 2501 W 22nd St, Sioux Falls, SD

57105.

PLACE OF PERFORMANCE:

Sioux Falls VA Health Care System

2501 West 22nd Street

Sioux Falls, SD 57105

PERIOD OF PERFORMANCE:

This will be a single Indefinite Delivery, Indefinite Quantity (IDIQ) contract with a period of performance of 07-01-2019 to 06-30-2024.

Funding will be obligated via issuance of task orders against the IDIQ contract during ordering periods as follows:

Ordering Period Begins Ends

1 07-01-2019 06-30-2020

2 07-01-2020 06-30-2021

3 07-01-2021 06-30-2022

4 07-01-2022 06-30-2023

5 07-01-2023 06-30-2024

Task orders will be issued by the Government at its discretion based on continued need for services, Contractor performance, and availability of funds for task order in a given fiscal year.

HOURS OF SERVICE:

Contractor shall provide service 7 days a week, 24 hours a day, including weekends and holidays, for the period of performance of this contract.

REGULATORY REQUIREMENTS:

All work under this contract shall be performed in accordance with any applicable US Department of

Transportation or OSHA regulations, as well as applicable SD State EMS Codified Laws and standard industry practice. SD State EMS Codified Laws can be accessed at:

http://doh.sd.gov/providers/ruralhealth/EMS/laws.aspx

REQUIRED STATE LICENSURE:

Contractor shall provide a copy of licensure from South Dakota Department of Health at http://doh.sd.gov/providers/ruralhealth/EMS/AmbulanceService.aspx at time of award. Contractor shall have competency in Advanced Life Support (ALS) and Basic Life Support (BLS).

DEFINITIONS:

1. Administration Officer of the Day (AOD) – Person identified and appointed by the VAMC as the

Administration Officer of the Day (AOD)

2. Advanced Life Support (ALS) - Advanced diagnosis and protocol-driven treatment of a patient in the field.

3. Ambulance - On highway vehicles that conform to the United States Department of Transportation

(DOT) General Services Administration, Ambulance Design and Construction Specifications

(KKK-A-1822, KKK-A-1822E as amended, revised or replaced) that are in effect at the date of vehicle production.

4. Authorized Government Employee is someone on the “Authorized Call List” which will be provided at time of award listing those who can order service. This list will include the COR and AOD.

5. Basic Life Support (BLS) - Basic lifesaving and life sustaining interventions.

6. Contracting Officer (CO) - Government employee who is warranted by the Government to enter into contracts on behalf of the Government and is the only person authorized to make changes to those contracts.

7. Contracting Officer Representative (COR)- Individual or Individuals designated by the Contracting

Officer to place orders, furnish technical guidance, advice, certify invoices, and provide general supervision of the work performed under the executed contract.

8. Critical Care Advance Life Support (CC-ALS) - Medical care provided by Paramedics.

9. Emergency Medical Technician (EMT) - a certified health care provider who has successfully completed and maintains the U.S. Department of Transportation (USDOT) National Standard

Curriculum for EMT-Basic.

10. Emergency Medical Technician Paramedic (EMT-P) - A certified health care provider who has successfully completed and maintains the U.S. Department of Transportation (USDOT) National

Standard Curriculum for EMT-P in order to provide advanced life support. This includes use of intravenous therapy (IV), drug therapy, intubations (breathing tube), and defibrillation.

11. Physician - A person who is licensed and legally authorized to practice medicine.

12. Prescribed Radius or City limits is defined as a 20 mile radius around the SFVAHCS location.

13. Registered Nurse (RN) - A licensed professional who is able to provide all levels of nursing care including the administration of medication.

14. Responsible Party – A person and/or agency that meets the requirements of accepting responsibility verbally and/or written.

15. Service Ordering Number – Number assigned by the COR and/or the AOD. The number will consist of the year, month, day, and 3 digit sequential number of request for that day (for example, http://doh.sd.gov/providers/ruralhealth/EMS/laws.aspx http://doh.sd.gov/providers/ruralhealth/EMS/AmbulanceService.aspx the first request of January 01, 2020 would be 20200101001)

16. SFVAHCS – Sioux Falls Veterans Affairs Healthcare System.

17. Twenty (20) Mile Radius - the city limits or prescribed radius for the purpose of this contract, are defined as follows: Twenty (20) miles surrounding the SFVAHCS location

18. VA Beneficiaries" are defined as authorized patients of SFVAHCS. For purposes of this contract, the term "patient(s)" and "passenger(s)" are defined to be VA Beneficiaries.

RESPONSE TIME:

a. Emergent Ambulance Services: Contractor shall commence transportation of the patient within thirty (30) minutes of notification of patient pick-up from the authorized Government Employee.

b. Non - Emergent Ambulance Services If transportation services are pre -arranged or scheduled in advanced, the Contractor shall commence transportation of the patient within ten minutes of the pre-arranged or scheduled time for patient pick-up. Otherwise, the Contractor shall commence transportation of the patient within thirty (30) minutes of notification from the authorized Government Employee. The contractor shall be notified at least 24 hours in advance of the desired pick-up date and time.

In the event that when service is ordered the Contractor advises that they cannot begin the transportation within these above response time constraints, SFVAHCS may contact another ambulance company to provide these services.

PATIENT TRANSPORTATION:

a. Contractor shall not release the patient from his/her custody, unless custody is released to a predetermined responsible party. Contractor shall take every measure to assure the well-being of the patient at destination. Patients brought in by ambulance for a scheduled clinic appointment shall be delivered directly to that specific clinic, released to the custody of clinic personnel, and picked up in the clinic after the appointment by the ambulance staff.

b. Number of Patients: It is understood and agreed that only one (1) patient will be transported on a trip unless specifically authorized by the VAMC. When more than one (1) patient is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient.

Additionally, when travel beyond the city limits (defined as 20 mile radius of the SFVAHCS) is involved, the longest distance over which a patient is transported may be claimed when more than one

(1) patient is transported in a single ambulance concurrently. Contractor must ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

c. The contractor shall not refuse to transport VA patients deemed transportable by VA medical staff.

d. Contractor will not be expected to accept any VA patient unless the COTR/designee (Administrative

Officer of the Day- AOD) authorizes the trip and informs the contractor regarding any special treatment or care required on route (such as administration of oxygen or medication).

e. Contractor shall transport patient belongings and patient specialized equipment at no additional charge.

f. It may be determined advantageous for the VAMC to assign its own attendant to accompany a patient.

Contractor will be notified of this fact at time trip is arranged. In such cases, contractor shall return the attendant to origin if the attendant requests return to origin.

ORDERING SERVICES:

a. Requests for services both Emergent and Non- Emergent will be made in writing (facsimile, e-mail, mail) or by telephone by an authorized representative of the VA. When ordering services, the VA shall provide the Contractor with the following type of information:

(1) Required date and time of arrival

(2) Name of Beneficiary

(3) Pick-up and delivery point

(4) Type and number of additional medical care specialists required

(5) Any other special instructions

(6) Service Ordering Number

b. In the case of inclement weather, the contractor shall determine if it is safe to transport the VA beneficiary. If the contractor determines it is unsafe to transport the patient due to weather, the VA reserves the right to contact other Ambulatory vendors to determine if another ambulatory service is capable to transport the VA beneficiary safely. If the transport is a Non-Emergent and time permits contact the COR to determine transport options.

c. The contractor shall, at all times during the contract period, have on his/her premises a functioning fax machine to communicate requirements with the VA (i.e., requests for service, patient incidents, special correspondence, etc.). Each contractor shall indicate if there is e-mail availability for their company to complete communications with the VA (use of this communication system will be mutually agreed upon after award of contract concerning which of the above communication systems will be used as the primary means). The contractor shall initially address 90% of daily contacts regarding questions and/or problems by telephone. The contractor shall maintain a telephone log identifying the date, time, subject of the call, and whether or not the problem was addressed and/or corrected. The contractors telephone log shall be made available to the COR at his/her request for review.

WAITING TIME:

a. The contractor shall not wait over (30) thirty minutes for transportation of Sioux Falls VAHCS patients, without receiving further payment. For time lost waiting at either end or both ends of the trip due to causes beyond the contractor’s control, the contractor shall be reimbursed at the rate specified in the schedule of supplies and services. If the pick-up is other than at the SFVAHCS, the Contractor shall call the COR/COR designee as the Contractor anticipates that a delay will develop for which they expect to claim reimbursement. This call is only for the purposes of verifying arrival time at the pick-up point and is not necessary if the Contractor anticipates no delay for which he/she shall claim reimbursement. The Contractor shall be responsible for all costs incurred in verifying waiting time.

b. Waiting time shall not apply to the reasonable amount of time required for loading and unloading of patients at the destination nor the departure location.

c. Upon request by authorized facility staff, Contractor shall wait for Sioux Falls VAHCS patients for return to facility if the time from delivery to location to expected return time is of half hour or less. If wait is to be in excess of half hour, Contractor will not wait for return trip.

RATES:

a. For all one-way trips within prescribed radius (defined as a 20-mile radius of the SFVAHCS), the

Contractor shall receive a flat base rate awarded for that trip. The flat base rate shall constitute full compensation for trips that do not exceed the prescribed radius.

b. For all trips for the same patient within a 24 hour period within the prescribed radius will be considered a round-trip and will not incur a second flat (base rate) charge and will be billed at the

Round Trip rate.

c. The Contractor shall receive the flat base rate (pick up charge) and a mileage rate (loaded only) in excess of the prescribed radius. The mileage rate is applicable only for mileage beyond the prescribed radius and under no circumstances shall the contractors receive reimbursement for any mileage within the prescribed mile radius.

d. Payment for mileage traveled beyond the city limits will be limited to "one way loaded only" - the distance over which the patient is transported. Payment for mileage travel beyond the prescribed radius shall be limited to the shortest distance according to Rand McNally’s Trip Maker (address to address), over which the patient is transported. Access Rand McNally’s Trip Maker is at https://www.randmcnally.com/home/ie.

e. The Contractor will be reimbursed at full contract amount for “No Loads” (trips made by the Contractor when the VA patient is not available at the scheduled pickup time). If pre-planned transport converts to no-load transport outside the 20 mile radius, the Pickup charge and loaded one way mileage charges apply.

f. For trips scheduled for the same day, there shall be no charge to the Government for cancellations made prior to the vehicle being dispatched.

https://www.randmcnally.com/home/ie

VEHICLES:

a. The ambulance under the terms of this contract will be licensed and meet the minimum vehicle requirements as mandated by the SD State Codified Laws 34-11 http://legis.state.sd.us/statutes/DisplayStatute.aspx?Statute=34-11&Type=StatuteChapter, SD

Department of Health Administrative Rules 44:05 http://legis.state.sd.us/rules/DisplayRule.aspx?Rule=44:05, and any other federal, state or city laws.

b. The Contractor shall provide a list of vehicles that will be used in the performance of this contract. The list shall include the mode of transportation that the vehicle is providing, bumper number and Vehicle

Identification Number. The Contractor shall also provide a copy of the most recent preventative maintenance checks and inspections.

c. Vehicles and equipment used in the performance of this contract must be clean and orderly and kept in excellent operating conditions at all times. The contractor shall make available on request any ambulance on the list of vehicles when requested by the COTR/COR and/or SFVAHCS Safety Officer for inspection. Each ambulance on the list shall be made available to the COTR/COR and/or

SFVAHCS Safety Officer once per quarter at a minimum not to exceed twice each per quarter unless a requirement exists in reviewing discrepancy corrections identified during inspection. In this case the ambulance in question shall be made available for inspection as many times needed until the discrepancy is corrected.

d. Maintenance of vehicle and equipment must be on a periodic basis and meet or exceed manufacturer's recommendations; documentation of maintenance must be kept on file at owner's premises or in the vehicle. Records of such maintenance must be made available for inspection to the Contracting Officer or designee upon request.

e. All vehicles shall be able to provide for both basic and advanced life support to include the ability to manage patients on mechanical ventilation and make available equipment for use when needed.

f. Contractor shall submit a list fully describing the make, model, year, and Vehicle Identification

Number (VIN) of the vehicle(s), which he/she will provide under the resultant contract, including the location and telephone number of the establishment where calls are received and where vehicles are immediately available for dispatch.

AMBULANCE MEDICAL EQUIPMENT:

Each ambulance shall be equipped in strict accordance with the standards as prescribed by South Dakota

State Laws and South Dakota Department of Health Administrative Rules.

INSPECTION:

Prior to final award and/or beginning of performance on the contract, the VA reserves the right to thoroughly inspect and investigate the Contractor's establishment, vehicles, facilities, business reputation, personnel training, qualifications, and other performance qualifications.

http://legis.state.sd.us/statutes/DisplayStatute.aspx?Statute=34-11&Type=StatuteChapter http://legis.state.sd.us/rules/DisplayRule.aspx?Rule=44:05

DRIVERS AND ATTENDANTS:

a. Record of each employee as to training, character and physical capabilities for performing the duties of an ambulance driver or EMT/paramedic shall be maintained and made available for inspection upon request by the COR or COR designee. Proof in the form of current certificates that appropriate training has been successfully completed shall be submitted to the COR if requested.

b. All drivers and medical personnel shall be certified, licensed or otherwise recognized by the local, state, or regional government or public entity where the ambulance service is operated or by which it is governed.

c. All drivers and medical personnel shall be enrolled periodically in "refresher" continuing education, or advanced training programs as required by the local or state government entity. Evidence of such refresher training shall be submitted to the COR if requested.

OTHER REQUIREMENTS:

a. Contractor employees shall conduct themselves in a businesslike manner at all times while on VA premises.

b. When transporting patients to or from medical facilities, the driver, acting for the Contractor, will ensure that patient’s luggage, medical records, medications, and prosthetic devices are properly accounted for and delivered with the patient as required.

COMPETENCY ASSESSMENTS OF CONTRACTOR PERSONNEL:

a. Contractors shall submit a copy of the Contractor’s competency assessments standards, a current competency assessment checklist, and the most recent competency assessment review for each employee proposed to work under this contract.

b. The contractor shall submit an annual statement of certification of State driving records, license verification, and insurance. Contractors must provide an annual statement that drivers are screened, trained, and competent to safely transport patients. The annual statement of driver competency must include any advanced certifications, such as Advanced Cardiac Life Support or specialized training to assist and secure patients by stretcher or wheelchair.

INCIDENT REPORTING:

a. Every effort shall be made by the contractor to prevent errors, falls and patient injury caused by acts of commissions or omission in the delivery of care.

b. Any adverse event related to patient injury or other patient safety issues will be reported to the COR verbally immediately following event and then followed by written notification (incident report) within one (1) business day. Root cause analysis will be conducted by the contractor to determine what happened, why it happened and what has been to done to prevent recurrence.

c. If the ambulance is involved in an automobile accident, a copy of the police report must be provided to the COR within five (5) business days of the accident.

INSURANCE:

a. The Contractor shall have the required levels of indemnification and liability insurance as outlined in

Section C of contract.

b. The certificate of insurance shall contain an endorsement to the effect, that cancellation of or any material change in the policies, which adversely affect the interests of the Government, shall not be effective unless a 30-day written notice of cancellation or change is furnished to the Contracting

Officer (CO).

c. Contractor shall provide certificate of insurance to the COR and CO within five (5) business days after post-award conference is held.

RECORDS MANAGEMENT:

Contractor shall maintain an accounting of disclosure of patient records and provide a copy to the COR upon request.

SAFETY REQUIREMENTS:

In the performance of this contract, the Contractor shall take such safety precautions as the Contracting Officer Representative (COR) or his/her designee may determine to be reasonably necessary to protect the lives and health of the occupants of the buildings and/or vehicles. The COR or his/her designee will notify the Contractor of any noncompliance with the forgoing provisions and the action to be taken. The Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or his/her designee at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the CO may consider all remedies available in the contract to pursue Contractor corrective action.

QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP):

The Contracting Officer Representative (COR) will utilize various methods to monitor contract performance. The COR will use the surveillance methods as listed below.

Purpose:

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

• What will be monitored?

• How monitoring will take place?

• Who will conduct the monitoring?

• How monitoring efforts and results will be documented?

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis.

However, the Government shall coordinate changes with the contractor through contract modification.

Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

Government Roles and Responsibilities:

The following personnel shall oversee and coordinate surveillance activities.

Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United

States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Contracting Officer’s Representative (COR) – The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Performance Standards:

The contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in “Performance Requirements.”. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

Methods of QA Surveillance:

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP:

RANDOM CHECKS: COR may, at any time, request copies of current licenses.

RANDOM INSPECTION: Random inspection will be done throughout the month to ensure that ambulance is staffed with applicable personnel.

DIRECT OBSERVATION; COR REPORT: COR will review reports on a monthly basis.

INSPECTION – TIMELY INVOICES: The COR reviews the invoice through the VA Invoice Payment

Processing System (IPPS) to ensure that the invoice is timely and accurate.

PERFORMANCE REQUIREMENTS

Measure

PWS

Reference

Performance

Requirement

Standard

Acceptable

Quality

Level

Surveillance

Method

Incentive Disincentive

Contractor

Vehicles “Vehicles”

Vehicles shall have current licenses and meet the requirements as outlined in the

PWS.

Licensing and registration information kept current.

PASS /

FAIL

Random

Checks

Favorable contractor performance evaluation.

Unfavorable contractor performance evaluation.

If recurrent violations occur, this could result in contract termination.

Timeliness “Response

Time”

Provide timely services to

VA

beneficiaries

Pick up VA beneficiaries within 30 minutes of notifications for Emergent

Ambulance

Service and within 10 minutes of scheduled time for

Non-

Emergent

Ambulance

Services

PASS /

FAIL

Direct

Observation;

COR Report

Favorable contractor performance evaluation.

VA may contact another source to perform the service

If recurrent violations occur, this could result in contract termination.

Timely

Invoicing

VAAR

Clause

852.232-72

“Electronic

Submission of Payment

Requests”

Submitted monthly

Invoices to be submitted electronically within 30 days at end of each month

PASS /

FAIL

Inspection

Favorable contractor performance evaluation.

Unfavorable contractor performance evaluation

Documenting Performance:

The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using

CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).

If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor.

This will normally be in writing unless circumstances necessitate verbal communication. In any case, the

CO shall document the discussion and place it in the contract file. When the COR and the CO determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.

The contractor shall acknowledge receipt of the CDR in writing within one (1) business day of receipt.

The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the CO. The

Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

Frequency of Measurement: The frequency of measurement is defined in the contract or otherwise in this document. The government (COR and CO) will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed. Any changes to QASP will be communicated to the Contractor and executed via bilateral contract modification.

Frequency of Performance Reporting: The COR shall communicate with the contractor on a quarterly and semi-annual basis. Formal written reports, as outlined in the contract, will be submitted to the CO for review of contractor performance.

SERVICE CONTRACT LABOR STANDARDS REQUIREMENT:

Contractor shall provide hourly wages in accordance with U.S. Department of Labor Wage Determinations and FAR Subpart 22.10 (Service Contract Labor Standards); see Attachment 1 (USDOL Wage Determinations).

POST-AWARD CONFERENCE:

Upon award of contract, Contractor shall attend a post-award conference via conference call with the

Contracting Officer (CO), Contracting Officer Representative (COR), and COR designated representatives from SFVAHCS.

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

ITEMS (OCT 2018)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any

Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the

Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR

52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the

Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds

Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other

Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by

EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act

(31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the

Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the

Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the

Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in

32.608-2 of the Federal Acquisition Regulation in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the Government using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred which reasonably could have been avoided.

(m) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the…