36C26322Q0022.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 89

36C26322Q0022 11-22-2021

Chris Skaggs Chris.Skaggs@va.gov 319-688-3619 12-22-2021

3:00 PM CST

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300 Coralville IA 52241

X

621610

$16.5 Million

N/A

X

See section B.1, #2 and #3 below. Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300 Coralville IA 52241

00636/90c

See section B.1, #2 and #3 below.

See CONTINUATION Page

DME (Durable Medical Equipment) storage, delivery, pick-up and repair. Services described below are required in the states of Iowa and Nebraska.

This solicitation describes an Indefinite Delivery Indefinite Quantity (IDIQ) requirement for 5 years.

See attached Department of Labor Wage Determination documents which apply to services described within this document; WD 15-4983 IA City, WD 15-4999 DSM, and WD 15-5005 Omaha.

Services to be furnished under this contract shall be ordered via placement of an purchase card orders.

See CONTINUATION Page Services to be furnished under this contract shall be issued by government purchase card orders.

Third party payment

X

Rick Grambo

Please submit all offers to chris.skaggs@va.gov by 3PM 12/22/21

36C26322Q0022

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 STATEMENT OF WORK

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.8 52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS (JUN 2013)

C.9 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.10 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF

COMMERCIAL ITEMS (APR 2020)

C.11 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND COMPLIANCE

(JUL 2018)

C.12 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE (JUL 2018)

C.13 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (OCT 2019) ... 50

C.14 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.15 52.223-99 Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors

C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES

OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021) (JUL 2020) (DEVIATION)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (SEP 2021)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

E.7 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS

(FEB 2021) (JUL 2020) (DEVIATION)

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

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300

Coralville IA 52241

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

[] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other []

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.

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0.00 N/A __________________ __________________

Iowa City, IA VAMC Base Year Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1001AA 498.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1001AB 125.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1001AC 265.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1001AD 5,000.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1002 0.00 N/A __________________ __________________ Des Moines, IA VAMC Base Year Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1002AA 238.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1002AB 60.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1002AC 183.00 HR __________________ __________________

The contractor shall provide an hourly fee rate to perform repairs when requested and approved by the Prosthetics & Sensory Aids service.

The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified here under and in accordance with the instructions outlined under “repairs of recovered equipment” of the general requirements of this solicitation.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1002AD 5,000.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1003 0.00 N/A __________________ __________________ Nebraska-Western Iowa (Omaha, Grand Island, Lincoln) VAMC Base Year Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1003AA 400.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1003AB 100.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1003AC 342.00 HR __________________ __________________

The contractor shall provide an hourly fee rate to perform repairs when requested and approved by the Prosthetics & Sensory Aids service.

The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified here under and in accordance with the instructions outlined under “repairs of recovered equipment” of the general requirements of this solicitation.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

1003AD 5,000.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 01-01-2022 POP End: 09-30-2022

2001 0.00 N/A __________________ __________________ Iowa City, IA VAMC Year 2 Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2001AA 523.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2001AB 131.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2001AC 273.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2001AD 5,150.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2002 0.00 N/A __________________ __________________ Des Moines, IA VAMC Year 2 Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2002AA 250.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2002AB 63.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2002AC 189.00 HR __________________ __________________

The contractor shall provide an hourly fee rate to perform repairs when requested and approved by the Prosthetics & Sensory Aids service.

The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified here under and in accordance with the instructions outlined under “repairs of recovered equipment” of the general requirements of this solicitation.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2002AD 5,150.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2003 0.00 N/A __________________ __________________ Nebraska-Western Iowa (Omaha, Grand Island, Lincoln) VAMC Year 2 Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2003AA 420.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2003AB 105.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2003AC 353.00 HR __________________ __________________

The contractor shall provide an hourly fee rate to perform repairs when requested and approved by the Prosthetics & Sensory Aids service.

The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified here under and in accordance with the instructions outlined under “repairs of recovered equipment” of the general requirements of this solicitation.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

2003AD 5,150.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2022 POP End: 09-30-2023

3001 0.00 N/A __________________ __________________ Iowa City, IA VAMC Year 3 Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3001AA 549.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3001AB 137.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3001AC 281.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3001AD 5,305.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3002 0.00 N/A __________________ __________________ Des Moines, IA VAMC Year 3 Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3002AA 263.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3002AB 66.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3002AC 194.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation

POP Begin: 10-01-2023 POP End: 09-30-2024

3002AD 5,306.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3003 0.00 N/A __________________ __________________ Nebraska-Western Iowa (Omaha, Grand Island, Lincoln) VAMC Year 3 Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3003AA 441.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3003AB 110.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3003AC 363.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

3003AD 5,305.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2023 POP End: 09-30-2024

4001 0.00 N/A __________________ __________________ Iowa City, IA VAMC Year 4 Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4001AA 577.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4001AB 144.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4001AC 290.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4001AD 5,464.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4002 0.00 N/A __________________ __________________

Des Moines, IA VAMC Year 4 Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4002AA 276.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4002AB 69.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4002AC 200.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4002AD 5,464.00 MI __________________ __________________

The contractor shall provide a rate for mileage for deliveries and pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

POP Begin: 10-01-2024 POP End: 09-30-2025

4003 0.00 N/A __________________ __________________ Nebraska-Western Iowa (Omaha, Grand Island, Lincoln) VAMC Year 4 Contract Period:

POP Begin: 10-01-2024

4003AA 463.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

POP Begin: 10-01-2024

4003AB

116.00 JB __________________ __________________

Fee for pick up of durable medical equipment. This fee shall include inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

4003AC

374.00 HR __________________ __________________

The contractor shall provide an hourly fee to perform repairs when requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

4003AD

5,464.00 MI __________________ __________________

pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

Iowa City, IA VAMC Year 5

Contract Period:

POP Begin: 10-01-2025 POP End: 09-30-2026

5001AA

480.00 JB __________________ __________________

Fee for delivery of durable medical equipment from the appropriate VA to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility

5001AB

108.00 JB __________________ __________________

inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

5001AC

298.00 HR __________________ __________________

requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

5001AD

5,628.00 MI __________________ __________________

pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

Des Moines, IA VAMC Year 5

Contract Period:

5002AA

290.00 JB __________________ __________________

to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

5002AB

72.00 JB __________________ __________________

inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

5002AC

206.00 HR __________________ __________________

requested and approved by the Prosthetics and Sensory Aids Service (PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

5002AD

pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

Nebraska-Western Iowa (Omaha, Grand Island, Lincoln) VAMC Year 5

Contract Period:

5003AA

486.00 JB __________________ __________________

to the beneficiary’s address. This fee shall include set-up, and training on the care and usage of the equipment and any time needed to prepare the equipment for delivery within a 50-mile radius of the closest VA Medical Facility Contract Period:

5003AB

122.00 JB __________________ __________________

inspection, and cleaning prior to storage at contractor’s facility or in the appropriate VA facility as instructed by VA authorized personnel within a 50-mile radius of the closest VA Medical Facility.

Contract Period:

5003AC

385.00 HR __________________ __________________

requested and approved by the Prosthetics and Sensory Aids Service

(PSAS). The contractor shall charge and invoice for this labor as a separate item in accordance with the rate specified herein and in accordance with the instructions outlined under "repairs of equipment" in the general requirements of this solicitation Contract Period:

5003AD

pickups made outside the 50-mile radius of each medical facility. The mileage shall be calculated using the distances provided by Mapquest at the following web-site: www.mapquest.com. The mileage charge will only be applicable one way.

Contract Period:

GRAND TOTAL __________________

B.3 STATEMENT OF WORK

DELIVERY OF DURABLE MEDICAL EQUIPMENT

OVERVIEW OF SERVICES: Contractor shall provide storage, delivery, installation, repair (when required) and pick-up of VA owned durable medical equipment for beneficiaries of the Department of Veterans Affairs (VA) Medical Centers in the Iowa City, Iowa, Omaha, Nebraska and Des Moines, Iowa patient service catchment area in strict accordance with the terms and conditions of this statement of work.

The VA intends to award a single Indefinite Delivery Indefinite Quantity (IDIQ) contract for a term of 5 years whereby one or more orders are placed when ordering services.

GOVERNMENT OWNED ITEMS: Contractor shall deliver or pick up recovered government-owned equipment, e.g. wheelchairs, power chairs, scooters, hospital beds, trapezes, patient lifts, wheelchair lifts, etc., in accordance with the terms, conditions and specifications set forth herein. Deliveries and pickups to be made at such times and in such quantities as required and as specified by the VA Contracting Officer or his/her designee. Delivery and pick up charges shall be in accordance with rates specified.

TIME FRAME FOR DELIVERY/PICKUP SERVICES: Contractor shall pick up or deliver an item or items within three working days from receipt of notification from the Program Manager, Prosthetics and Sensory Aids Service (PSAS), Contracting Officers Technical Representative (COR) or his/her designee. Contractor shall pick up or deliver an item within 24 hours when an emergency service is specified by the PSAS or COR. If a situation arises where the delivery cannot be scheduled within three working days after notification, the initiator of the VA delivery order shall be contacted immediately.

WORK HOURS: The services covered by this contract shall be furnished by the Contractor as defined herein. The Contractor shall be available as scheduled. The Contractor shall not be required, except in case of emergency, to furnish such services on a Federal Holiday or during off-duty hours as described below:

The following terms have the following meaning:

Work Hours: Monday through Friday, 8:00 a.m. to 4:30 p.m.

Non-Work Hours: Monday through Friday, 4:31 p.m. – 7:59 a.m., and all Saturdays and Sundays.

Federal Holidays: The holidays observed by the Federal Government are:

New Year’s Day January 1

Martin Luther King Jr. Birthday Third Monday in January

Presidents Day Third Monday in February

Memorial Day Last Monday in May

Independence Day July 4

Labor Day First Monday in September

Columbus Day Second Monday in October

Veterans Day November 11

Thanksgiving Day Fourth Thursday in November

Christmas Day December 25 or any other day specifically declared by the President of the United States of America to be a Federal Holiday. When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.

DELIVERY LOCATIONS: The following represents primary delivery locations for each VA Medical Center—this list is not all inclusive:

Geographic Area One: Iowa City, IA VA Medical Center:

The following counties Iowa: Allamakee, Benton, Blackhawk, Bremer, Buchanan, Cedar, Chickasaw, Clayton, Clinton, Delaware, Des Moines, Dubuque, Fayette, Henry, Howard, Iowa, Jackson, Jefferson, Johnson, Jones, Keokuk, Lee, Linn, Louisa, Mitchell, Muscatine, Poweshiek, Scott, Tama, Van Buren, Washington, Winneshiek

The following counties in Illinois but not limited to: Adams, Brown, Bureau, Carroll, Knox, Fulton, Hancock, Henderson, Henry, JoDaviess, Mason, McDonough, Mercer, Peoria, Rock Island, Schuyler, Stark, Warren and Whiteside.

The following counties in Missouri but not limited to: Adair, Atchison, Daviess, Grundy, Harrison, Mercer, Nodaway, Putnam, Schuyler, Scotland, Sullivan and Worth

Geographic Area Two: Des Moines and Knoxville, IA VA Medical Center:

The following counties in Iowa: Adair, Appanoose, Boone, Buena Vista, Butler, Calhoun, Carroll, Cerro, Gordo, Clarke, Dallas, Decatur, Floyd, Franklin, Green, Guthrie, Grundy, Hamilton, Hancock, Hardin, Humboldt, Jasper, Kossuth, Lucas, Madison, Marshall, Marion, Mahaska, Monroe, Palo Alto, Pocahontas, Polk, Ringgold, Sac, Story, Union, Wapello, Warren, Wayne, Webster and Wright.

The following counties in Missouri but not limited to: Harrison, Mercer, Putnam and Worth.

Geographic Area Three: Omaha, Lincoln and Grand Island, NE VA Medical Center:

In Nebraska, the following counties, but not limited to: Adams, Antelope, Arthur, Blaine, Boone, Brown, Buffalo, Burt, Box Butte, Butler, Cass, Cedar, Chase, Cherry, Clay, Colfax, Cuming, Custer, Dakota, Dawes, Dawson, Dixon, Dodge, Douglas, Dundy, Fillmore, Franklin, Frontier, Furnas, Garfield, Grant, Gage Gosper, Greeley, Hall, Harlan, Hamilton, Hayes, Holt, Hooker, Howard, Jefferson, Johnson, Keith, Keya Paha, Kearney, Knox, Lancaster, Lincoln, Logan, Loup, Madison, McPherson, Merrick, Morrill, Nance, Nemaha, Nuckolls, Otoe, Pawnee, Perkins, Pierce, Phelps, Platte, Polk, Red Willow, Richardson, Rock, Saline, Sarpy, Saunders, Seward, Sheridan, Sherman, Sioux, Stanton, Thayer, Thomas, Thurston, Washington, Wayne, Webster, Wheeler, Valley, and York.

In Western Iowa, the following counties, but not limited to: Fremont, Harrison, Mills, Monona, Montgomery, Page, and Pottawattamie. In Northwest Missouri, the following counties, but not limited to: Atchison, Holt, and Nodaway.

NON-SOLICITATION/NON-DISCRIMINATION: Contractor shall conduct business hereunder, only with the appropriate VA office and in no case deal directly with or solicit beneficiaries of the VA. The contractor shall provide all services specified in this contract for any person determined to be eligible by the PSAS, COR or his/her designee regardless of the race, color, sex, religion or national origin of the person(s) to whom such services are rendered. The contractor further warrants that he/she shall not resort to sub-contracting as a means of circumventing this provision.

QUALIFICATIONS: Offers shall be considered only from bidders who are regularly established home and healthcare businesses and who are financially responsible and have the necessary equipment, personnel and facilities to furnish service in the volume specified for all requirements under this contract. Successful contractors shall meet all requirements of the State and City codes regarding operations of this type of service.

Contractor must meet Joint Commission (or an equivalent accreditation body) standards for providing these services, and provide documentation of meeting such standards. The contractor shall be asked to submit a completed Periodic Performance Review (documentation of meeting Joint Commission standards) annually--90 days prior to the end of the contract period http://www.jointcommission.org/

EQUIPMENT, STORAGE AND INVENTORY CONTROLS: All equipment and supplies initially provided under the terms of this contract shall be jointly inventoried by the contractor and VA designated official. The property shall be immediately placed on the inventory listing by the contractor who must ensure an accurate inventory record is available and maintained at all times.

The contractor’s storage and repair facility shall be within the county of each individual VAMC or a border county, due to requirements for frequent VA inspections and pickups at the VAMC. The storage facility shall be a storefront facility.

The contractor shall maintain a separate, detailed cumulative inventory of all items stored under the terms of this contract. Inventory listing shall contain information as to the location, condition, disposition, manufacturer, model, serial number, and any modification(s) incorporated therein. It shall also include documentation that the items have been serviced, functioned checked, cleaned, and stored in accordance with the terms of the contract and Joint Commission standards. A copy of this inventory shall be provided to the COR after close of business on the last workday of each month.

All items listed on the inventory shall be made immediately available for issue/reissue. The contractor shall maintain a clean environment for storage and delivery of equipment and delivery vehicle(s).

Equipment management shall be compliant with established Joint Commission guidelines and standards.

All government owned property (GOP) shall have a VA provided identification label attached. The VA contracting officer or COR may conduct joint inventories at any time.

The contractor shall request disposition instructions for all items that can’t be reissued. The PSA Program Manager/ COR shall inform the contractor in writing of the method to be used for disposing of items. For items that leave the contractor’s possession for repairs or other authorized reasons, a receipt shall be obtained by the contractor and kept available for proper record keeping.

The contractor may be held financially liable for replacement cost for all property turned over to the contractor by the VA, or picked up from veteran beneficiaries upon request of the VA, when it can’t be accounted for as a result of joint inventories. Replacement equipment that is lost due to contractor negligence shall be purchased by the VA and the charged to the contractor.

DELIVERY/SET UP/ADJUSTMENTS AND INSTRUCTIONS OF GOP: When medical equipment that has been recovered from veteran beneficiaries is to be reissued, the contractor agrees to reissue these items first and to deliver, set up, adjust, and instruct in their care and use at the rate specified on this contract. If re-issued equipment is not available, the VA Prosthetics staff shall procure the item then the contractor shall deliver, or set-up, if drop shipped to the patient’s home. A receipt or notice of delivery showing contractor’s name, telephone number, and address shall be provided to the veteran/caregiver in the event service or repairs are required. The contractor shall furnish a delivery checklist, copy of the Patient Rights and Responsibilities, and verification of education to be signed and dated by the veteran/caregiver and the delivery person. A copy of this delivery checklist shall be included with each invoice submitted for payment.

HOSPITAL BED MATTRESSES: In all cases where a hospital bed is to be issued or re-issued, a new standard mattress shall be furnished. The contractor shall dispose of all standard mattresses recovered from VA beneficiaries. Specialty mattresses shall not be disposed of without the consent of the PSA Manager or COR.

PROOF OF DELIVERY: The contractor shall be responsible for insuring that the veteran/caregiver is home when delivery is scheduled. The government assumes no liability for additional trips required if no one is home when delivery is attempted. Contractor shall be required to provide proof of delivery. Proof of delivery shall be receipt of delivery checklist, signed and dated by the veteran/caregiver and delivery person.

PATIENT RECORDS: Records of deliveries, pick-ups, etc, to veteran beneficiaries shall be maintained at the contractors’ local office servicing this contract. Records shall include, but are not limited to, signed and dated delivery checklist, copy of patient education, copy of VA delivery order, and a copy of submitted invoice. Invoice shall contain name and address of Contractor, invoice date, patient name, date when order was received, service provided to patient and at what address and date of service. A copy of the patient record shall be submitted to the COR within 5 business days of the service rendered. Upon termination of this contract, the original records shall be given to the COR or designee within 30 days.

VHA Supplemental Contract Requirements for Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1. If fully vaccinated, shall show proof of vaccination.

i.NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2. If unvaccinated and granted a medical or religious exception, shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test.

3. Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

4. Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

3.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

ROLES AND RESPONSIBILITIES:

Role and/or Responsibility

VA Medical Center or designee

Contractor

1. Delivery Process VA Prosthetics staff shall review order, verify need, initiate delivery order and contact contract vendor.

Responsible for furnishing equipment and supplies as ordered to VA beneficiaries in a professional manner.

2. Patient Education Contract vendor shall supply VA Prosthetics staff with copies of the educational materials provided to patients for review and concurrence.

VA Prosthetics staff, in conjunction with the appropriate medical center staff, shall work to overcome any identified barriers to learning.

Responsible for providing comprehensive, easily understood, well documented patient education specific to the equipment delivered. Any barriers to learning shall be brought to the attention of VA Prosthetics staff immediately upon identification.

3. Home Assessment

VA Prosthetics shall respond to any concerns identified by the contractor regarding safety and appropriateness of the equipment to be set-up in the patient’s home. If VA Prosthetics is aware of any known potential environmental issues, every attempt shall be made to notify the contract vendor of these concerns. If

Responsible for evaluating the home environment to ensure that the equipment can be safely installed in the patient’s home. Any concerns related to safety or appropriateness of the equipment shall be immediately addressed with the PSAS Manager or COR prior to setting up equipment. All hazards associated with trips and falls shall be reported immediately.

deemed to be unsafe, shall refer back to the appropriate medical center staff to discuss with patient.

Any fall information verbalized by the patient shall be included with the report.

4. Discharge Planning

VA Prosthetics staff shall contact the contract vendor when an item needs to be picked up from a patient’s home.

The contract vendor shall pick up the identified item. By the end of the billing period the contract vendor shall send verification of the pickup, including description of the item and the serial number when applicable.

STORAGE OF RECOVERED EQUIPMENT: Recovered equipment shall be tagged as GOP, numbered for inventory purposes and shall include the name of the beneficiary from whom such equipment was recovered. GOP shall be kept segregated from contractor-owned equipment. A current inventory of equipment shall be kept at all times and shall irregularly be inspected and verified by the program manager, PSAS or his/her designee. Such inspections shall be conducted at the contractor’s storage facility and copy of the current inventory shall be furnished to the VA at that time. The contractor shall be notified in advance should a veteran or caregiver wish to pick up GOP in person. There shall be no charge for such a pick up.

The contractor shall provide a clean, pest/rodent free, secure contained area, with approximately 1000 square feet of space per medical center facility, for the storage of Government-owned supplies and equipment covered under this…