36C26321Q0228.docx

36C26321Q0228

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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

PR 618-21-3-155-0004

36C26321Q0228 01-07-2021 Angela Beck 605.720.7314 02-09-2021 11:00

MST

36C568 Department of Veterans Affairs Network 23 Contracting Office (NCO 23) 113 Comanche Rd.

Fort Meade SD 57741 X 621910 $16.5 Million N/A X 36C618 Department of Veterans Affairs VA Minneapolis Health Care System One Veterans Drive Minneapolis MN 55417 36C568 Department of Veterans Affairs Network 23 Contracting Office (NCO 23) 113 Comanche Rd.

Fort Meade SD 57741

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page Important notice to Offerors:

Review and follow INSTRUCTIONS TO OFFERORS in Clause 52.212-1 Addendum.

Note block #28 - this document must be signed and returned to the Contracting Officer by the Offer Due Date in order to be considered. E-mail ALL required and completed documents to ANGELA BECK: angela.beck@va.gov This is an RFQ for Minneapolis VA Health Care System Ground Ambulance & Litter/Gurney Transport Services.

The Government intends to award a Firm Fixed Priced Requirements contract with four option year periods on an unrestricted competitive basis using the LPTA process under FAR Parts 13 and 13.5.

***Submit any written questions via e-mail - no telephonic questions will be accepted. Responses to questions pertaining to this solicitation will be provided through JAN 20, 2021 only.

See CONTINUATION Page 618-3610160-155-829800 Patient Care Tra- 2119 Beneficiary tvl- other th-010041088

***AS CITED ON EACH TASK ORDER***

X X X

ONE

ANGELA BECK

Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C263 Angela Beck Department of Veterans Affairs Network 23 Contracting Office (NCO 23)

113 Comanche Rd.

Fort Meade SD 57741

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

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PERFORMANCE WORK STATEMENT

VA MINNEAPOLIS Health Care System (MVAHCS)

GROUND AMBULANCE AND LITTER/GURNEY TRANSPORT

1. Description of Services: Ground Ambulance and Litter/Gurney Transport. The Contractor shall pick up all qualified VA beneficiaries from designated locations and transport to the MVAHCS or previously identified destinations. The contractor shall furnish standard and bariatric emergency, non-emergency ambulance, and littler/gurney services for the beneficiaries of the Department of Veterans Affairs Health Care System in Minneapolis, MN. Transports may include, but are not limited to, providing services to the following locations: Minnesota, Iowa, Wisconsin, North Dakota, South Dakota, and Nebraska. The quantity of trips and mileages indicated in the Price Schedule are estimated only and were based upon historical data for the approximate 1-YEAR period of OCT 2019 – SEP 2020. The Government makes no guarantee that these estimates will become actual quantities of trips or mileages. When scheduling, the mode of transportation, will be discussed and determined by the MVAHCS clinical personnel. The Contractor will transport per its policies and standard industry practices.

2. Hours of Service: Contractor shall provide services 7 days/week, 24 hours/day, including weekends and holidays, for the term of this contract.

3. Eligible VA Patients: VA will pay transportation costs only for eligible VA patients as determined by VA regulations. Contractor may contact the VA Mobility Manager or designee if there are any questions concerning eligibility.

4. 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 MN State EMS Codified Laws, and standard industry practice. MN State EMS Codified Laws can be accessed at: http://mn.gov/health-licensing-boards/emsrb/.

5. Definitions

a. 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.

b. Litter/Gurney transport- Non-emergent transport requiring the use of a litter or gurney.

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

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

e. Critical Care/Specialty Care Transport- Critical care or Specialty Care transportation requiring medical care provided by but not limited to advanced medic Paramedics., RN, Respiratory Therapist, or medical provider ( MD, DO, FNP, PA-C).

f. 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.

g. Contracting Officer Representative (COR) - Individual or Individuals designated by the Contracting Officer to place orders, furnish technical guidance, certify invoices, and provide general supervision of the work performed under the executed contract.

h. 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.

i. 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.

j. MVAHCS – Minneapolis Veterans Affairs Health Care System.

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

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

m. Authorized Government Employee is someone on the “Delegation of Authority to Order Transportation Services” memorandum which will be provided at time of award listing those who can order transportation services.

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

6. Response Time

a. Emergent Ambulance Services BLS/ALS: Contractor shall commence transportation of the patient within 60 minutes of notification/transport call request of patient pick-up from the authorized Government Employee. Critical Care/Specialty Care transport shall commence of the patient within 90 minutes of notification/transport call request. Emergent ambulance services will only originate from the Minneapolis VAHCS for the purpose of diverting a patient to another medical facility. Upon notification of the emergent ambulance service needed, the Contractor must arrive at the Minneapolis VAHCS within thirty (60) minutes of this notification. If the Contractor is unable to fulfill this request, they will procure transport by use of a qualified subcontractor. Subcontractor will bill Contractor and MVAHCS will reimburse at prescribed rates identified within this contract.

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 (10) minutes of the prescheduled time for patient pick-up. For non-emergent transports that are not prescheduled, or not having a 24-hour advanced notice, the Contractor must arrive at the destination facility within sixty (60) minutes of the desired pick up time. The Contractor shall commence transportation of the patient within 70 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 for prescheduled transports to include one-way transportation requiring transport of greater than 150 miles. If the contractor is unable to pickup the patient within the allotted time, they must notify the COR or Beneficiary Travel Depart within 30 minutes of the identified pick up time by phone.

Furthermore, for non-emergent transports that are not prescheduled, the desired pick up time will be an agreed upon time between the COR, or designee, and the Contractor – travel distance, weather, traffic, patient safety, etc. will all be considered when negotiating the desired pick up time.

c. Litter/Gurney Transportation If transportation services are pre-arranged or scheduled in advanced, the Contractor shall commence transportation of the patient within 60 minutes of the pre-arranged or scheduled time for patient pick-up. Otherwise, the Contractor shall commence transportation of the patient within thirty 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 for prescheduled transports to include one-way transportation requiring transport of greater than 150 miles.

d. The contractor shall furnish standard and bariatric emergency, non-emergency ambulance and littler/gurney service for the beneficiaries of the Department of Veterans Affairs Health Care System in Minneapolis, MN. Transports may include but not limited to providing services to the following locations: Minnesota, Iowa, Wisconsin, North Dakota, South Dakota, Nebraska etc.

e. Limitation to the use of ambulances utilized up to three (3) at any one period of time and one (1) litter/gurney transport van. We can often do more, but this gives us some reassurance during periods of peak volume that we are not contractually bound to provide more.

f. Provide a minimum of at least 12 hours’ notice for trips that originate or terminate more than 200 miles from the Twin Cities Metro area in order to ensure assignment of a fresh crew for the sake of safety.

g. For trips that originate further than 75 miles or more from the Twin Cities metro area, the MPLS VHA assures a minimum of 50% of that distance as a mileage charge. The purpose is to mitigate a financial loss in the event a new facility such as a dialysis center or outpatient care clinic is brought online.

h. Transport requests will be given a 24-hour or greater notice; however, in rare occurrences, the Minneapolis VAHCS may request a long distance (>150 miles) transport without giving a 24 hour or greater notice. If the Contractor determines that any transport may be unsafe for any reason, the Contractor is to contact the COR, or designee, to discuss transportation options.

i. In the event that when service is ordered the Contractor advises that they cannot begin the transportation within these above response time constraints, MVAHCS may contact another vendor to provide services. All expenses incurred for this rate, will be billed to the contractor via written notification with a bill of collection.

j. In the event the MPLS VHA chooses to find additional transportation for a call because contractor is unable to perform, the vendor will pay the other services normal and customary published non-discounted rates. The MPLS VHA understands this would be a financial penalty to the contractor and will discourage utilizing outside services. In tandem, contractor shall be allowed to generate a charge to the VA as if contractor provided the service, because the service was, in fact, provided on the contractor’s behalf. The purpose is to limit financial exposure to contractor; the goal, of course, is to provide all the service the MPLS VHA requires.

7. 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 MVAHCS. 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.

c. Contractor shall notify the Contracting Officer or designee of any unusual events including, but not limited to, accidents and safety problems that occur that involve VA patients being transported under this contract. This notification will be made within one (1) hour by telephone and, if requested, a written report of the event will be delivered to the Contracting Officer or designee no later than 4:30pm the next business day. Failure to comply with this provision may be ground for default.

d. Contractor shall not refuse to transport VA patients deemed transportable by VA medical staff.

e. Contractor will not be expected to accept any VA patient unless an authorized Government employee authorizes the trip and informs the contractor regarding any special treatment or care required on route (such as administration of oxygen or medication).

f. Contractor shall transport patient belongings (no more than 2 pieces of standard luggage not to exceed 50lbs/piece) and patient specialized durable medical equipment (DME) at no additional charge. This includes but is not limited to power wheelchair/power car, manual wheelchair, walker, etc. at no additional charge.

g. It may be determined advantageous for the MVAHCS to assign its own attendant to accompany a patient. Contractor will be notified of this at the time the trip is arranged. In such cases, the contractor shall return the attendant to origin if the attendant requests return to origin at no additional charge.

8. 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 Beneficiary Travel Dept. Minneapolis VAMC; this includes the Administrative Officer of the Day (AOD) and Health Admin Services. When ordering services, the VA shall provide the Contractor with the following type of information:

(1) Mode of transportation required (Basic Life Support (BLS), Advanced Life Support(ALS), Critical Care Transport (CCT)/Specialty Care Transport (SCT)

(2) Required date and time of arrival

(3) Name of Beneficiary

(4) Height and weight of patient

(5) Pick-up and delivery point

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

(7) Any other special instructions

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 will contact other vendors to determine if another service is capable to transport the VA beneficiary safely. If there is another service that is tasked by the VA to complete transport of the VA beneficiary and has agreed that they can accomplish the task safely, the Contractor shall be responsible for expenses incurred for this service at the rate billed by the vendor performing the task, and billed to the contractor via written notification with a bill of collection. If the transport is non-emergent and time permits, contact the COR, or designee, 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 contractor’s telephone log shall be made available to the Contracting Officer or designee at his/her request for review.

9. Waiting Time

a. The contractor shall not wait over fifteen (15) minutes for transportation of MVAHCS 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 MVAHCS, the Contractor shall call the COR, or 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 MVAHCS 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.

10. Rates & Billing

a. The Contractor cannot charge the Minneapolis VA HCS for services not performed. The Minneapolis VA HCS will make every effort to work with the contractor if issues directly related to response times set forth in the contract if they unable to be fulfilled. Examples may include inclement weather or traffic congestion.

b. The Contractor shall receive a base rate (pick up charge) and a mileage rate (loaded only).

c. The base rate will apply to a loaded one-way trip and will include fifteen (15) minutes of waiting time on each end of the trip.

d. The mileage rate will be charged from pick-up point to destination. Contractor’s odometer will be used to measure actual miles driven.

e. For all trips for the same patient within a 24 hours period will be considered a round-trip and will not incur a second base rate charge and will be billed at the mileage rate (loaded only).

f. The Contractor will be reimbursed the base rate for “No-Loads” (trips made by the Contractor when the VA patient will not be ready for transport for an hour or more) that occur at the MVAHCS. If pre-planned transport converts to no-load transport outside the MVAHCS (i.e. patient refuses transport) the base rate and loaded one-way mileage charges from pick-up point to destination will apply.

g. There shall be no charge to the Government for cancellations made prior to the vehicle being dispatched.

h. For transports under this contract, the Contractor is responsible for submitting invoices electronically to the VA Financial Services Center (VA FSC). The VA FSC use may us a third-party contractor, e.g. Tungsten Network or eCAMS (Electronic Claims Adjudication Management System), to assist vendors in submitting invoices electronically, free of charge. Once a valid and proper invoice under this contract has been submitted electronically to the correct agency, the Minneapolis VAHCS follows the Prompt Payment Act under 31 U.S.C. Chapter 39. Invoice submission is subject to change however notification will be given in advance.

i. The contractor shall provide ambulance transport for humanitarian (non-veteran or ineligible veteran) transferring to Twin Cities area hospitals. Transports will be direct billed to ineligible veteran/humanitarian at NON-CONTRACT rates. The ordering agent will identify patient’s status as veteran or humanitarian and also provide any and all applicable demographics to include insurance information.

j. No transport volume guarantee will be made for the identified services requested in this contract other than 1 transport.

11. Vehicles

a. The ambulances provided under the terms of this contract must meet the standards for vehicle and equipment established by the EMSRB (to include inspections of facility, vehicle, employee education records, and vehicle maintenance). The government will consider inspections as conducted by EMSRB. However, the government does not waive its right to conduct inspections on either a scheduled or unscheduled basis (see paragraph 13).

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 COR and/or MVAHCS Patient Safety Officer for inspection.

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. Smoking in any portion of the ambulance is prohibited.

12. Ambulance Medical Equipment: Each ambulance shall be equipped in strict accordance with the standards as prescribed by the MN EMSRB and carry at least the minimal equipment necessary for the type of service to be provided, as determined by standards adopted by the board.

13. Inspection: Prior to final award the VA reserves the right to thoroughly inspect and investigate the bidder's establishment, vehicles, facilities, business reputation, personnel training and qualifications, and other performance qualifications. The VA also reserves the right to reject any proposal, irrespective of price, if it shall be administratively determined lacking any of the essentials necessary to assure acceptable standards of performance.

14. 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 must be maintained and made available for inspection upon request by the Contracting Officer or designee. Proof in the form of current certificates that appropriate training has been successfully completed must submitted to the COR if requested.

b. All drivers and medical personnel must 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 must 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 must be submitted to the COR if requested.

15. Miscellaneous

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.

c. Before award of the Contract, the Contractor shall furnish to the Contracting Officer a certificate of insurance which 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 30-day written notice of cancellation or change is furnished to the Contracting Officer.

d. If any portion or work is subcontracted, subcontractor will be contractor for all charges. VA will only provide reimbursement for amounts prescribed within this contract.

16. Qualifications

a. Offers will be considered only from bidders who are regularly established in the ambulance business and who are financially responsible and have the necessary equipment and personnel to furnish ambulance services as required for this contract. The offeror shall submit a current copy of their ambulance license and current certificates of appropriate licenses and training for drivers or EMT/Paramedics as required by MN EMSRB.

b. Prior to award, the successful bidder shall submit a list, in duplicate, fully describing the make, model and year 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.

c. Indicate the number of years the offeror has been providing Ground Ambulance Transportation services.

17. Competency Assessments Contractor Personnel

a. Bidders shall submit a copy of the bidder’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.

18. 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) working day. Root cause analysis will be conducted by the contractor to determine what happened, why it happened and what has been 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.

Quality Assurance Surveillance Plan (QASP) Ambulance Litter Transport Services

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) is a Government developed and applied document used to make sure that systematic quality assurance methods are used in the administration of the Performance Based Service Contract (PBSC) standards included in this contract. The intent is to ensure that the Contractor performs in accordance with performance metrics set forth in the contract documents, that the Government receives the quality of services called for in the contract and that the Government only pays for the acceptable level of services received.

2. SCOPE

To fully understand the roles and the responsibilities of the parties, it is important to first define the distinction in terminology between the Quality Control Plan and the Quality Assurance Surveillance Plan. The Contractor, and not the Government, is responsible for management and quality control actions necessary to meet the quality standards set forth in the contract. The Contractor develops and submits his/her Quality Control Plan (QCP) for Government approval in compliance with his contract deliverables. Once accepted, the Contractor then uses the QCP to guide and to rigorously document the implementation of the required management and quality control actions to achieve the specified results. The QASP on the other hand, is put in place to provide Government surveillance oversight of the Contractor’s quality control efforts to assure that they are timely, effective and are delivering the results specified in the contract. The QASP is not a part of the contract nor is it intended to duplicate the Contractor’s QCP. The Government may provide the Contractor an information copy of the QASP as an Attachment to the solicitation to support the Contractor’s efforts in developing a QCP that will interrelate with the Government’s QASP.

3. GOVERNMENT RESOURCES/RESPONSIBILITIES

a. CONTRACTING OFFICER: The Contracting Officer (C.O.) ensures performance of all necessary actions for effective contracting, ensures compliance with the terms of the contract and safeguards the interests of the United States in the contractual relationship. It is the Contracting Officer that assures the Contractor receives impartial, fair, and equitable treatment under the contract. The Contracting Officer is ultimately responsible for the final determination of the adequacy of the Contractor’s performance.

Assigned CO: Angela G. Beck Organization or Agency: Department of Veterans Affairs, VHA

b. Contracting Officer’s Representative (COR) - The COR provides detailed technical oversight of the Contractor’s performance and reports his or her findings to the C.O. in a timely, complete and impartial fashion. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. Any changes that the Contractor deems may affect contract, price, terms, or conditions shall be referred to the Contracting Officer for action.

Assigned COR: Amy Colbaugh, Facility Contract Liaison, MVAHCS

4. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed in the above matrix chart for the administration of this QASP.

a. PERIODIC INSPECTION (AUDITING). Evaluates outcomes on a periodic basis. Inspections may be scheduled [Daily, Weekly, Monthly, Quarterly, or annually] or unscheduled, as required.

b. VALIDATED USER/CUSTOMER COMPLAINTS. Relies on the patient to identify deficiencies. Complaints are then investigated and validated.

c. OBSERVATION and 100% INSPECTION. Evaluates all outcomes.

5. Performance Standards The Performance Requirements Summary in the Performance Work Statement (PWS), includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL), and determine incentives.

6. Incentives The Government shall use CPARs Evaluation Ratings (Excellent +) as incentives. Incentives shall be based on exceeding the satisfactory performance standards.

7. RATINGS

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome.

Required Services (Tasks)

EXAMPLES:

Ground Ambulance Service

Certifications and Training

Submit Timely Reports

Ambulance Maintenance/Safety

The vendor may write their own CPARs, subject to review and approval of the Contracting Officer for excellent service.

8. DOCUMENTING PERFORMANCE

a. ACCEPTABLE PERFORMANCE The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. UNACCEPTABLE PERFORMANCE When unacceptable performance occurs, the COR shall inform the Contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file. When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the Contractor's Program Manager. The Contractor shall acknowledge receipt of the CDR in writing. 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 COR. The Government shall review the Contractor's corrective action plan to determine acceptability. Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

c. EXCEPTIONAL PERFORMANCE The Government shall document exceptional performance. Any report may become a part of the supporting documentation for any contractual action. Incentives are then applicable.

FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR shall meet with the contractor semi-annually to assess performance and shall provide a written assessment.

**SIGN THIS DOCUMENT AFTER AWARD AND PRIOR TO PERFORMANCE**

Signature – Contractor Date:

Signature – Contracting Officer’s Representative Date:

Signature – Contracting Officer Date:

Price Schedule - VA MINNEAPOLIS Health Care System (MVAHCS)

Base Year: POP 4/1/21- 3/31/22 :

Item Description

EST.

Qty

Price Base Year Pricing:

Litter/Gurney/ BLS Wait time per quarter hour (beyond initial quarter hour)

19500

ALS Base Rate/Loads (includes first 15 minutes of wait time)

BASE YEAR TOTAL

Option Year 1 POP 4/1/22-3/31/23 :

Description

Option Year 1 Pricing:

OPTION YEAR 1 TOTAL

Option Year 2 POP 4/1/23-3/31/24

Description

Option Year 2 Pricing:

OPTION YEAR 2 TOTAL

Option Year 3 POP 4/1/24-3/31/25

Description

Option Year 3 Pricing:

OPTION YEAR 3 TOTAL

Option Year 4 POP 4/1/25-3/31/26

Description

Option Year 4 Pricing:

OPTION YEAR 4 TOTAL

Price Schedule - VA MINNEAPOLIS Health Care System (MVAHCS)

GROUND AMBULANCE AND LITTER/GURNEY TRANSPORT

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 52.216-18 ORDERING (AUG 2020)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from the effective date of the contract through contract completion.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) A delivery order or task order is considered "issued" when—

(1) If sent by mail (includes transmittal by U.S. mail or private delivery service), the Government deposits the order in the mail;

(2) If sent by fax, the Government transmits the order to the Contractor’s fax number; or

(3) If sent electronically, the Government either—

(i) Posts a copy of the delivery order or task order to a Government document access system, and notice is sent to the Contractor; or

(ii) Distributes the delivery order or task order via email to the Contractor’s email address.

(d) Orders may be issued by methods other than those enumerated in this clause only if authorized in the contract.

(End of Clause)

C.2 52.216-19 ORDER LIMITATIONS (OCT 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $25.00, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor—

(1) Any order for a single item in excess of $20,000;

(2) Any order for a combination of items in excess of $40,000; or

(3) A series of orders from the same ordering office within one (1) calendar days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within three (3) calendar days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of Clause)

C.3 52.216-21 REQUIREMENTS (OCT 1995)

(a) This is a requirements contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies or services specified in the Schedule are estimates only and are not purchased by this contract. Except as this contract may otherwise provide, if the Government's requirements do not result in orders in the quantities described as "estimated" or "maximum" in the Schedule, that fact shall not constitute the basis for an equitable price adjustment.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. Subject to any limitations in the Order Limitations clause or elsewhere in this contract, the Contractor shall furnish to the Government all supplies or services specified in the Schedule and called for by orders issued in accordance with the Ordering clause. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(c) Except as this contract otherwise provides, the Government shall order from the Contractor all the supplies or services specified in the Schedule that are required to be purchased by the Government activity or activities specified in the Schedule.

(d) The Government is not required to purchase from the Contractor requirements in excess of any limit on total orders under this contract.

(e) If the Government urgently requires delivery of any quantity of an item before the earliest date that delivery may be specified under this contract, and if the Contractor will not accept an order providing for the accelerated delivery, the Government may acquire the urgently required goods or services from another source.

(f) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after the contract's effective period..

(End of Clause)

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 15 calendar days of expiration.

(End of Clause)

C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 15 calendar days of expiration; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 30 calendar days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any…