36C26325R0004 0004.pdf
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- Solicitation number
- 36C26325R0004
About this file
This document is a modification to a solicitation issued by the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 23 for Audiology Health Technician Services. The purpose of the modification is to replace the Schedule of Services.
The key details are:
- The contractor shall provide onsite Audiology Health Technician Services to eligible beneficiaries at two locations - the Minneapolis, MN VA Medical Center and the Twin Ports, WI Community-Based Outpatient Clinic.
- The contract consists of a base period from 3/12/2025 to 3/11/2026 and four 1-year option periods.
- The contractor shall propose a minimum of five key Audiology Health Technicians and provide pricing for each position by location.
- The total estimated hours for the base and option periods is 52,000 hours.
- Pricing instructions are provided, including the requirement to edit the number of Sub-Line Item Numbers to match the number of key personnel submitted.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C26325R0004_7.docx | DOCX document | |
| 36C26325R0004 0006.pdf | ||
| 36C26325R0004_6.docx | DOCX document | |
| 36C26325R0004 0005.pdf | ||
| 36C26325R0004_5.docx | DOCX document | |
| 36C26325R0004 0003.pdf | ||
| 36C26325R0004_4.docx | DOCX document | |
| 36C26325R0004 0002.pdf | ||
| 36C26325R0004_3.docx | DOCX document | |
| 36C26325R0004_2.docx | DOCX document | |
| 36C26325R0004 0001.pdf | ||
| S02 - 36C26325R0004.pdf | ||
| D.6 Organizational Conflict of Interest.pdf | ||
| 36C26325R0004_1.docx | DOCX document | |
| D.1 VA Rules of Behavior.pdf | ||
| D.2 Background Investigation Procedure and Documents.pdf | ||
| D.3 Quality Assurance Surveillance Plan - QASP.pdf | ||
| D.5 VA Handbook 6500.6.pdf | ||
| D.4 Immigration and Nationality Act Requirement.pdf |
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Text version
5. PROJECT NUMBER (if applicable)
CODE 7. ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF PAGES
10A. MODIFICATION OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO. 1. CONTRACT ID CODE
FACILITY CODE CODE
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR
ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES
SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED STATES OF AMERICA
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 30 PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243
(Type or print) (Type or print)
(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code)
(If other than Item 6)
(Specify type of modification and authority)
(such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign) (Signature of Contracting Officer)
1 8
0004 N/A
36C263
Department of Veterans Affairs
NETWORK 23 CONTRACTING OFFICE
Daniel Vagts
316 Robert Street N. STE. 506
St. Paul MN 55101
Department of Veterans Affairs
NETWORK 23 CONTRACTING OFFICE
316 Robert Street N. STE. 506
St. Paul MN 55101
To all Offerors/Bidders 36C26325R0004
X
X 1
Purpose of this amendment is to replace the Schedule of Services.
Daniel Vagts
Contract Officer
VA-VHA-SAOC-2019-161D3612
SCHEDULE OF SERVICES
The Contractor shall furnish all key personnel to provide services necessary to perform onsite
Audiology Health Technician Services to eligible beneficiaries of the Department of Veterans
Affairs, One Veterans Drive, Minneapolis, MN 55417 or Twin Ports CBOC, 3520 Tower Avenue, Superior WI 54880.
The services are accredited by The Joint Commission (TJC) and follow the standards & guidelines set forth by The American College of Physicians (encompassing all of internal medicine) and the Society of Hospital Medicine: https://www.hospitalmedicine.org. A contractor providing onsite Audiology Health Technician Services shall provide services that meet or exceed those guidelines.
Place of Performance: Services shall be provided on site, One Veterans Drive, Minneapolis, MN
55417 or Twin Ports CBOC, 3520 Tower Avenue, Superior WI 54880.
Pricing Instructions:
The offeror is instructed to edit the number of Sub-Line Item Numbers (SLIN) to correspond with the number of key personnel submitted for the line item number (LIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber
SLINs if adding or removing Key Personnel.
The Contractor shall propose a minimum of five (5) key personnel Audiology Health Technicians to be credentialed and be available for scheduling to meet the requirements of the contract.
Period of Performance: BASE PERIOD: 3/12/2025 to 3/11/2026
LIN
No.
SUB-
LIN
Description Qty. Unit Unit Cost
Total
Annual Cost
0001 None Audiology Health Technician
Services 10,400 Hours DO NOT
PRICE
DO NOT
PRICE
KEY PERSONNEL
None 0001a
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $ https://www.hospitalmedicine.org/
None 0001b
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 0001c
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 0001d
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 0001e
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: TWIN PORTS
2,080 Hours $/hr $
TOTAL FOR BASE PERIOD 10,400 Hours
OPTION PERIOD 1: 3/12/2026 to 3/11/2027
LIN
No.
SUB-
LIN
Description Qty. Unit Unit Cost
Total
Annual Cost
1001 None Audiology Health Technician
Services 10,400 Hours DO NOT
PRICE
DO NOT
PRICE
KEY PERSONNEL
None 1001a
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 1001b
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 1001c
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 1001d
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 1001e
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: TWIN PORTS
2,080 Hours $/hr $
TOTAL FOR OPTION PERIOD 1 10,400 Hours
OPTION PERIOD 2: 3/12/2027 to 3/11/2028
LIN
No.
SUB-
LIN
Description Qty. Unit Unit Cost
Total
Annual Cost
2001 None Audiology Health Technician
Services 10,400 Hours DO NOT
PRICE
DO NOT
PRICE
KEY PERSONNEL
None 2001a
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 2001b
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 2001c
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 2001d
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 2001e
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: TWIN PORTS
OPTION PERIOD 3: 3/12/2028 to 3/11/2029
TOTAL FOR OPTION PERIOD 2 10,400 Hours
LIN
No.
SUB-
LIN
Description Qty. Unit Unit Cost
Total
Annual Cost
3001 None Audiology Health Technician
Services 10,400 Hours DO NOT
PRICE
DO NOT
PRICE
KEY PERSONNEL
None 3001a
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 3001b
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 3001c
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 3001d
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
OPTION PERIOD 4: 3/12/2029 to 3/11/2030
None 3001e
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: TWIN PORTS
2,080 Hours $/hr $
TOTAL FOR PERIOD 3 10,400 Hours
LIN
No.
SUB-
LIN
Description Qty. Unit Unit Cost
Total
Annual Cost
4001 None Audiology Health Technician
Services 10,400 Hours DO NOT
PRICE
DO NOT
PRICE
KEY PERSONNEL
None 4001a
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 4001b
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 4001c
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
Total for base performance period and all option periods: $
None 4001d
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: MSP
2,080 Hours $/hr $
None 4001e
Audiology Health Technician
Services NAME:____________
TITLE:
LOCATION: TWIN PORTS
2,080 Hours $/hr $
TOTAL FOR PERIOD 4 10,400 Hours
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