36C26327Q0038.pdf

PAGE 1 OF1. 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. UEI: EFT:

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. NOV 2021)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C26327Q0038 10-21-2026

Cameron Rick 651-293-3036 11-06-2026 12:00pm CST

36C263

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 23

316 ROBERT STREET N, SUITE 506

SAINT PAUL MN 55101

X 100

X

621330

$9 Million

N/A

X

36C618

DEPARTMENT OF VETERANS AFFAIRS

Minneapolis Health Care System

1 Veterans Dr.

Minneapolis MN 55417

36C263

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 23

316 ROBERT STREET N, SUITE 506

SAINT PAUL MN 55101

Y

DEPARTMENT OF VETERANS AFFAIRS

FINANCIAL SERVICES CENTER

PO BOX 149971

AUSTIN TX 78714-9971

See CONTINUATION Page

This solicitation is to provide services to the Minneapolis Health Care System.

See SOW for VA Police Psychological Evaluation requirements.

Note block 30 - This document must be signed and returned in order to be considered. Email all required and completed documents to: cameron.rick@va.gov.

Submit questions via email by 12:00PM Central, October 29, 2026.

**No telephonic questions will be accepted.**

Responses to questions will be posted as an amendment to the solicitation.

Solicitation will close at 12:00PM Central on November 06, 2026.

This is a total SDVOSB set-aside.

See CONTINUATION Page

X X

X X X 1

Cameron Rick Contracting Officer

36C26327Q0038

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

STATEMENT OF WORK

QUALITY ASSURANCE SURVEILLANCE PLAN

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (OCT 2025) (DEVIATION)

C.2 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.3 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ...31

C.4 52.222-90 ADDRESSING DEI DISCRIMINATION BY FEDERAL CONTRACTORS

(DEVIATION APR 2026)

C.5 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025)

(DEVIATION)

C.6 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.7 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF

VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION, Minneapolis VA Health Care System, AND See attached document: Records Management Language for Contracts _ National Archives

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (OCT 2025) (DEVIATION)

ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

ITEMS

E.2 52.212-2 Evaluation—Commercial Products and Commercial Services (October 2025)

E.3 52.216-1 TYPE OF CONTRACT (NOV 2025) (DEVIATION)

E.4 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS

AND CERTIFICATIONS (NOV 2025) (DEVIATION)

E.5 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

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 Cameron Rick

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 23

316 ROBERT STREET N, SUITE 506

SAINT PAUL MN 55101

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

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

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

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

STATEMENT OF WORK

VA POLICE OFFICER PSYCHOLOGICAL EVALUATION SERVICES

1. DESCRIPTION OF SERVICES

The Department of Veterans Affairs (VA), Minneapolis VA Health Care System (MVAHCS), requires professional psychological evaluation services for VA Police Officer applicants and incumbent VA Police Officers. The Contractor shall provide qualified professional services necessary to assess psychological fitness to safely and effectively perform the functional requirements of a VA Police Officer.

The Contractor shall perform all required services in accordance with VHA Directive 0730(1), Psychological Evaluations of VA Police Officers, as amended February 5, 2021 (or latest version available), applicable VA policy, and the requirements of this SOW.

The Contractor shall provide all professional personnel, administrative support, materials, psychological testing resources, equipment, and other resources necessary to perform the services required by this SOW, except for resources specifically identified as Government-furnished.

Services shall include:

1. Pre-employment psychological evaluations of VA Police Officer applicants;

2. Periodic (annual) psychological evaluations of incumbent VA Police Officers; and

3. Directed or special Fitness-for-Duty (FFD) psychological evaluations of incumbent VA Police

Officers when referred and authorized by the Government.

The Government will identify the individual requiring evaluation and the applicable evaluation type. The Contractor shall perform the required evaluation components specified in this SOW and VHA Directive 0730(1), while exercising appropriate professional judgment in selecting and applying evaluation methods consistent with the purpose of the evaluation.

The services performed under this contract are nonpersonal services. Contractor personnel shall not be subject to Government supervision or control of the type that characterizes an employer-employee relationship.

2. DEFINITIONS AND TERMINOLOGY

For purposes of this SOW, the following definitions apply:

Complete Government Referral: A written referral issued or authorized by MVAHCS Human Resources (HR) containing the information necessary for the Contractor to begin the requested evaluation. For a directed or special FFD evaluation, the referral includes a written summary articulating the reason the employee's ability to perform essential job functions has come into question and the applicable job-related referral question(s).

Completed Evaluation: Completion of all required evaluation activities and secure delivery of the required Police Officer Recommendation Report to the Government-designated recipient.

Contracting Officer's Representative (COR): The Government representative designated by the Contracting Officer to perform authorized contract surveillance and administration functions.

Directed or Special Fitness-for-Duty (FFD) Evaluation: An evaluation of an incumbent VA Police Officer referred by HR to address specific job-related concerns regarding the officer's psychological ability to perform essential job functions.

Periodic (Annual) Psychological Evaluation: A recurring psychological evaluation of an incumbent VA Police Officer conducted as part of the applicable annual medical evaluation process.

Pre-employment Psychological Evaluation: An evaluation of a VA Police Officer applicant focused on the functional requirements of the position, suitability, and stability for the role.

3. PLACE OF PERFORMANCE

Psychological evaluations under this contract may be performed remotely via telehealth.

Services may also be performed on-site at MVAHCS, 1 Veterans Drive, Minneapolis, Minnesota 55417, or at an appropriate Contractor-provided or Contractor-arranged location, consistent with the requirements of this SOW.

When services are performed on-site at MVAHCS, the Government will provide an Occupational Health examination room suitable for conducting the evaluation.

If on-site performance becomes necessary and is authorized by the Government, the Contractor shall coordinate facility access in advance with the COR. Contractor personnel shall be escorted while in the facility in accordance with applicable VA policy.

Contractor personnel do not require access to VA information systems, electronic health records, or VA patient records to perform the services required by this SOW and shall not access such systems or records unless separately authorized by the Government.

When services are performed at a Contractor-provided or Contractor-arranged physical location, the location shall provide an appropriate, private, and professional environment suitable for psychological evaluations and protection of confidential information. The Contractor shall provide all personnel, equipment, materials, supplies, and other resources necessary at that location.

For evaluations conducted remotely, administration procedures shall be maintained as close as practicable to traditional in-person procedures and the use of remote procedures shall be documented in the written report. Remote administration of psychological testing shall include audio-visual monitoring when required by VHA Directive 0730(1). The Contractor shall use a non-public-facing video platform that meets applicable privacy and security requirements, enable available encryption and privacy safeguards, and follow test-publisher guidance for remote administration of specific instruments.

4. PERFORMANCE REQUIREMENTS

4.1 Evaluator Qualifications

Evaluations shall be conducted only by actively licensed psychologists or psychiatrists who are qualified by education, training, and experience to conduct psychological assessments.

Licenses may be held in any state the evaluator is located. If services are performed on-site at the MVAHCS, Evaluators must be licensed in the state of Minnesota.

Evaluators shall be trained in psychological evaluation of Police Officers, including assessment of clinical and normal personality characteristics relevant to Police Officer selection and retention. Specific mandated courses or number of hours are not required. Evaluators shall be familiar with VA policies relevant to the evaluation and selection of VA Police Officers and knowledgeable regarding employment laws applicable to these personnel evaluations.

An evaluator shall not perform a psychological evaluation of a VA Police Officer or applicant whom the evaluator is treating in any setting. The Contractor shall identify and appropriately resolve any actual or potential dual relationship or conflict of interest before assigning an evaluator.

The Contractor shall maintain current documentation demonstrating compliance with evaluator qualification requirements and provide such documentation prior to the evaluator's performance of services and upon Government request.

Upon contract start and as required during contract performance, evaluators must review VHA Directive 0730 (Psychological Evaluations of VA Police Officers) and VA Handbook 5019 (Employee Occupational Health Service). VA partnered with the American Board of Professional Psychology to offer 8 hours of continuing education on VHA Directive 0730 and the conduct of psychological evaluation of Police Officers; The course number is TMS #44403, Psychological Evaluations of Police Officers (sessions 1-4).

4.2 Contractor Personnel and Government Relationship

The Contractor shall be responsible for the management, supervision, direction, and control of its personnel performing services under this contract. Contractor personnel remain employees or representatives of the Contractor and shall not be considered employees of the Government.

Government personnel may communicate contract requirements, provide referral information, coordinate performance, inspect and accept services, and perform contract surveillance. Such activities shall not constitute supervision or control of Contractor personnel.

4.3 Professional Standards

The Contractor shall perform evaluations in accordance with VHA Directive 0730(1), applicable VA requirements, and applicable professional standards governing occupationally mandated psychological evaluations and psychological evaluations of law-enforcement and public-safety personnel.

Psychological tests and assessment instruments shall be administered, scored, interpreted, and documented by appropriately qualified personnel and in accordance with applicable professional standards and test-publisher requirements.

4.4 Required Evaluation Components

Before conducting any psychological evaluation, the evaluator shall obtain written authorization from the applicant or employee. At a minimum, the authorization shall identify the nature and objectives of the evaluation, intended recipient(s) of the information, probable uses of the evaluation information, and limits of confidentiality. The Contractor may use the authorization form template in Appendix A of VHA Directive 0730(1) or another form that satisfies the Directive.

Every evaluation shall include an individual interview conducted by the psychologist or psychiatrist. The interview shall be conducted in a consistent and comprehensive manner, focus on information relevant to the purpose of the evaluation, and adhere to applicable professional and industry standards.

The evaluation shall include review of the individual's history to the extent pertinent to the purpose of the evaluation and shall focus on the functional requirements of the VA Police Officer position, suitability, and stability for the role.

4.5 Pre-employment Psychological Evaluations

The Contractor shall evaluate designated VA Police Officer applicants to assess psychological fitness to meet the functional requirements of the position, as well as suitability and stability for the role.

In addition to the requirements of Section 4.4, each pre-employment evaluation shall include a written psychological test battery consisting of at least two psychological tests:

1. One broadband measure of normal-range personality traits; and

2. One broadband measure of psychopathology and personality problems.

Testing shall include appropriate validity measures and shall be relevant to the purpose of the evaluation. The evaluation shall also address substance abuse and symptoms of other mental health disorders to the extent they may impede effective functioning as a VA Police Officer.

4.6 Periodic (Annual) Psychological Evaluations

The Contractor shall evaluate designated incumbent VA Police Officers to assess continued psychological fitness to meet the functional requirements of the position. Periodic evaluations recur every 12 months in accordance with VHA Directive 0730(1).

Each periodic evaluation shall include the authorization and individual interview requirements in Section 4.4. Standardized screening instruments may be used when professionally appropriate.

Additional psychological testing shall be conducted when the interview or screening and assessment tools raise concern regarding functional ability, stability, or suitability. A positive screening response alone shall not be used as grounds for a final recommendation.

4.7 Directed or Special Fitness-for-Duty Evaluations

HR may refer an incumbent VA Police Officer for a directed or special FFD psychological evaluation when objective evidence indicates that the employee's ability to perform essential job functions may be compromised and the concern may involve a mental or psychological condition. The evaluation shall be performed only upon referral and authorization by HR and within the applicable occupational-health framework.

The Government shall provide a written summary articulating the reason the employee's ability has come into question, the specific job-related referral question(s), and relevant information the Government determines appropriate. The Contractor shall conduct an individualized evaluation sufficient to address the referral question(s).

The evaluation shall include the authorization and interview requirements in Section 4.4.

Psychological testing shall be used when the interview or screening and assessment tools raise concern regarding functional ability, stability, or suitability, or when otherwise required by the Government consistent with applicable policy and professional standards.

4.8 Timeliness

The Contractor shall complete each evaluation and securely deliver the required Police Officer Recommendation Report to the Government-designated recipient within 30 calendar days after receipt of a complete Government referral.

An evaluation is considered complete only when the required evaluation activities have been performed and the completed recommendation report has been securely delivered to the Government-designated recipient.

If circumstances outside the Contractor's reasonable control prevent completion within the required period, the Contractor shall notify the COR as soon as the delay becomes known, identify the reason for the delay, and provide the anticipated completion date.

4.9 Failure or Refusal to Participate

The Contractor shall notify the COR within three calendar days after the Contractor determines that a referred individual has failed to respond to reasonable scheduling attempts, failed to appear for a scheduled evaluation, declined to participate, or otherwise prevented completion of the evaluation.

The Contractor shall document the circumstances sufficiently to permit the Government to determine appropriate administrative action. The Government retains sole responsibility for determining any administrative or employment action resulting from an individual's failure or refusal to participate.

5. REPORTS AND DETERMINATIONS

5.1 Police Officer Recommendation Report

The Contractor shall prepare a Police Officer Recommendation Report for each completed evaluation in accordance with VHA Directive 0730(1) and the report framework in Appendix C of that Directive.

The report shall address the individual's psychological ability to meet the functional requirements of the VA Police Officer position. The evaluation shall consider the psychological screening dimensions identified in VHA Directive 0730(1), including social competence, teamwork, adaptability/flexibility, conscientiousness/dependability, impulse control/attention to safety, integrity/ethics, emotional regulation/stress tolerance, decision-making/judgment, assertiveness/persuasiveness, and avoidance of substance abuse/other risk-taking behavior, as applicable to the evaluation.

The evaluator's recommendation shall be unequivocal when the available evidence supports such a recommendation. If the individual does not meet applicable functional requirements, the compromised functional requirement(s) shall be documented. If the available information is insufficient to support an unequivocal recommendation, the report shall describe the insufficiency and any additional information needed to resolve it.

The report shall include only information pertinent to the purpose and findings of the evaluation.

A clinical diagnosis, if made, shall not itself be the basis for a negative recommendation; the report shall address functional impairment relevant to the requirements of the position.

The Contractor's professional recommendation assists the Government in its determination and does not constitute the Government's final hiring, retention, fitness-for-duty, disciplinary, or other employment decision.

5.2 Report Delivery

The Contractor shall securely transmit the Police Officer Recommendation Report to the MVAHCS Employee Occupational Health (EOH) provider designated by the Government.

Reports may be transmitted by secure email or fax, using Government-approved procedures that comply with applicable privacy, information-security, and confidentiality requirements.

The Contractor shall not routinely provide raw psychological test data, testing documents, interview notes, or other underlying evaluation materials to HR, selecting officials, VA Police leadership, or other Government personnel. Disclosure of such materials shall occur only when specifically authorized or required by applicable law, regulation, VA policy, or Government direction.

6. CONFIDENTIALITY AND RECORDS

The Contractor shall safeguard all personally identifiable information, medical information, psychological information and records, test materials, evaluation reports, and other sensitive information generated, received, maintained, or accessed in performance of this contract.

The Contractor shall establish and maintain administrative, technical, and physical safeguards against unauthorized access, use, disclosure, alteration, or loss. Psychological personnel-evaluation information shall not be entered into the VA Electronic Health Record or other clinical systems except when expressly authorized by applicable VA policy.

Raw psychological evaluation materials, including testing documents and interview notes, shall remain in the custody of the psychologist or psychiatrist unless disclosure is otherwise authorized or required. The Contractor shall maintain psychological evaluations, testing, handwritten notes, and related mental-health evaluation records for seven years in accordance with VHA Directive 0730 records-management memorandum and applicable records schedules.

The Police Officer Recommendation Report transmitted to MVAHCS EOH will be maintained by the Government in the employee medical folder in accordance with applicable VA policy. The Contractor shall disclose evaluation information only as authorized by applicable law, regulation, VA policy, the individual's authorization, and the contract.

7. PROCEDURE AND WORKFLOW

7.1 Government Referral

MVAHCS HR is the Government office authorized to initiate administrative psychological evaluations under this SOW. HR will identify the individual requiring evaluation and provide or authorize the applicable referral.

A complete Government referral shall identify the individual, evaluation type, Government point of contact, and information necessary for the Contractor to understand the functional requirements and purpose of the evaluation. For a periodic evaluation, HR shall provide the written request and documented reason required by applicable VA policy. For a directed or special FFD evaluation, HR shall provide a written summary articulating why the employee's ability to perform essential job functions has come into question and the specific job-related referral question(s).

The applicable performance period begins on the date the Contractor receives a complete Government referral. The performance period is 30 calendar days for all evaluation types. If information required to begin the evaluation is missing, the Contractor shall promptly notify the COR and identify the missing information. The applicable performance period begins when the Contractor receives the information necessary to constitute a complete referral.

7.2 Scheduling

Upon receipt of a complete Government referral, the Contractor shall contact the referred individual and coordinate scheduling of the evaluation. MVAHCS HR may facilitate the initial connection between the individual and the Contractor; Occupational Health is not required to coordinate scheduling.

The Contractor shall schedule the evaluation sufficiently in advance to permit completion of all required evaluation activities and secure delivery of the recommendation report within the applicable performance period.

7.3 Evaluation

The Contractor shall obtain the required written authorization and conduct the evaluation in accordance with the applicable evaluation type, VHA Directive 0730(1), this SOW, and applicable professional standards.

7.4 Report Preparation and Delivery

Following completion of the evaluation activities, the Contractor shall prepare and securely deliver the Police Officer Recommendation Report in accordance with Section 5. The evaluation is complete for contract-performance purposes only upon secure delivery of the report to the designated MVAHCS EOH provider.

7.5 Government Determination

Following receipt of the recommendation report, the Government will make any applicable hiring, retention, fitness-for-duty, administrative, or other employment determination. The Contractor shall not make administrative or employment decisions on behalf of the Government.

8. DELIVERABLES

Deliverable Requirement Due

Evaluator Qualification Documentation

Current documentation demonstrating compliance with Section 4.1

Prior to performance by the evaluator and upon Government request

Police Officer Recommendation Report

Completed evaluation and recommendation report delivered in accordance with Sections 4 and 5

Within 30 calendar days after receipt of a complete Government referral for all evaluation types

Quarterly Activity Report

Complete and accurate report of contract activity and applicable performance information

No later than 10 business days after the close of each calendar quarter

Invoice Accurate invoice reflecting completed and accepted evaluation services

Upon completion and acceptance of applicable services

8.1 Quarterly Activity Report

The Contractor shall submit a Quarterly Activity Report to the COR summarizing contract activity and performance during the reporting period. The report shall be submitted no later than 10 business days after the close of each calendar quarter. The report shall include, at a minimum:

1. Number of complete Government referrals received;

2. Number of evaluations completed;

3. Number of evaluations pending at the end of the reporting period;

4. Evaluation type for each referral - pre-employment, periodic/annual, or directed/special FFD;

5. Number and percentage of completed evaluations for which the recommendation report was delivered within the applicable performance period;

6. Identification and status of evaluations exceeding the applicable performance period, including the reason for delay; and

7. Other contract-performance information reasonably required by the COR to verify compliance with this SOW.

The Quarterly Activity Report shall not contain unnecessary clinical, medical, psychological, or other sensitive information concerning evaluated individuals.

8.2 Invoicing

The Contractor shall submit invoices upon completion of the applicable evaluation services. An evaluation may be invoiced after the required Police Officer Recommendation Report has been securely delivered to the designated MVAHCS EOH provider and the service has been accepted by the Government.

The Contractor shall submit invoices electronically through the Tungsten Network in accordance with VAAR 852.232-72, Electronic Submission of Payment Requests, and all other applicable invoicing requirements of the contract.

Each invoice shall accurately identify the applicable contract number, Contract Line Item Number (CLIN), evaluation type, quantity of services completed and accepted, applicable unit price, and other information required for a proper invoice. The Contractor shall not invoice for evaluations that have not been completed and accepted by the Government.

The Government will pay only for evaluation services completed in accordance with this SOW and accepted by the Government. No payment will be made for missed appointments, cancellations, incomplete evaluations, or other services for which the required Police Officer Recommendation Report has not been securely delivered to the designated MVAHCS EOH provider.

9. QUALITY ASSURANCE AND GOVERNMENT SURVEILLANCE

The Government will evaluate Contractor performance to determine compliance with the requirements of this SOW. The Contractor is responsible for maintaining quality-control procedures sufficient to ensure that services and deliverables consistently meet contract requirements.

Government surveillance may include review of evaluator qualifications, referral and report-delivery dates, recommendation reports and other deliverables, Quarterly Activity Reports, Contractor notifications, privacy or security incidents, and other records necessary to assess contract performance.

The COR will monitor and document the performance objectives and surveillance frequencies established in the Quality Assurance Surveillance Plan (QASP). Performance deficiencies and other significant performance issues may be documented through applicable contract-administration processes, including the Contractor Performance Assessment Reporting System (CPARS), as appropriate.

For timeliness surveillance, the performance period begins when the Contractor receives a complete Government referral and ends when the required recommendation report is securely delivered to the designated MVAHCS EOH provider. Delays demonstrably resulting from circumstances outside the Contractor's reasonable control may be considered in the Government's performance assessment when adequately documented by the Contractor.

QUALITY ASSURANCE SURVEILLANCE PLAN

For: VA Police Officer Psychological Evaluation Services

Contract Number:

Contract Description: Psychological Evaluation Services for VA Police Officer Applicants and Incumbent VA Police Officers, Minneapolis VA Health Care System (MVAHCS)

Contractor’s name:

1. PURPOSE

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

What will be monitored.

How monitoring will take place.

Who will conduct the monitoring.

How monitoring efforts and results will be documented.

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

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship.

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

Assigned CO: Cameron Rick Organization or Agency: Department of Veterans Affairs, Network Contracting Office 23

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

Assigned COR: Matthew D. Murphy, Program Analyst/COR, MVAHCS Primary and Specialty Care Integrated Clinical Community (ICC)

3. CONTRACTOR REPRESENTATIVES

The following employee of the contractor shall serve as the contractor’s program manager for this contract.

a. Program Manager – ______________________________

4. PERFORMANCE STANDARDS

Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards.

The Performance Requirements Summary Matrix (attached) includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

5. INCENTIVES

The Government shall use Exercise of Option Period and past performance as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance standards.

6. METHODS OF QA SURVEILLANCE

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

Task ID Performance Objective SOW Reference Performance Standard

Acceptabl e Quality Level

Method of Surveillance Incentive

1 Evaluator Qualifications

4.1 – Evaluator Qualifications

Each evaluator performing services meets the qualification, training, and conflict-of-interest requirements of the SOW, and required qualification documentation is provided prior to performance.

100%

100% review of qualification documentation prior to evaluator performance and upon personnel changes.

Exercise of Option Period and positive past performance evaluation

2 Evaluation Timeliness

4.8 – Timeliness;

7.1 – Government Referral;

8 – Deliverables

Required evaluation activities are completed and the Police Officer Recommendation Report is securely delivered within 30 calendar days after receipt of a Complete Government Referral.

95%

Review of referral and report-delivery dates, Quarterly Activity Reports, and Government records.

Exercise of Option Period and positive past performance evaluation

Recommendatio n Report Compliance

5.1 – Police Officer Recommendation Report;

5.2 – Report Delivery

Police Officer Recommendation Reports contain the required elements and are prepared and securely delivered in accordance with the SOW.

95%

Review of required report elements and feedback from the designated EOH provider, as appropriate.

Exercise of Option Period and positive past performance evaluation

Privacy, Confidentiality, and Security

3 – Place of Performance;

6 – Confidentiality and Records

Contractor safeguards sensitive information, psychological materials, and records and complies with applicable privacy, confidentiality, security, and remote-performance requirements.

100%

Review of reported incidents, Contractor notifications, Government observations, and relevant contract records.

Exercise of Option Period and positive past performance evaluation

Required Contractor Notifications

4.8 – Timeliness;

4.9 – Failure or Refusal to Participate

Contractor provides required notifications concerning known delays and failure or refusal of referred individuals to participate within the timeframes established by the SOW.

95% Review of Contractor notifications and associated referral/performance records.

Exercise of Option Period and positive past performance evaluation

6 Quarterly Activity Report

8.1 – Quarterly Activity Report

Contractor submits a complete and accurate Quarterly Activity Report no later than 10 business days after the close of each calendar quarter.

100% 100% review of each Quarterly Activity Report.

Exercise of Option Period and positive past performance evaluation

a. 100% INSPECTION. All occurrences of the applicable performance requirement are reviewed. This method will normally be used for evaluator qualification documentation and Quarterly Activity Reports.

b. PERFORMANCE RECORD REVIEW. Contractor and Government records may be reviewed and compared to determine compliance with measurable contract requirements.

Records may include referral dates, report-delivery dates, Quarterly Activity Reports, required contractor notifications, and other applicable contract-administration records.

c. DELIVERABLE AND GOVERNMENT CUSTOMER/USER REVIEW. Required deliverables may be reviewed to determine compliance with applicable SOW requirements. Relevant feedback from Government personnel receiving or relying upon Contractor deliverables, including the designated MVAHCS Employee Occupational Health (EOH) provider, may be considered. Review of psychological recommendation reports shall be limited to information necessary to determine contract compliance and shall be conducted consistent with applicable privacy and confidentiality requirements.

d. INCIDENT, NOTIFICATION, AND TARGETED REVIEW. The COR may review privacy or security incidents, required Contractor notifications, reported delays, failure or refusal to participate notifications, and other performance events relevant to determining compliance with the SOW. When surveillance identifies a potential deficiency, recurring problem, adverse trend, or other performance concern, the COR may increase the frequency or scope of surveillance for the affected requirement.

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. The ratings are defined in Section 9.

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/designee shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR/designee shall document the discussion and place it in the COR file.

When the CO determines formal written communication is required, the CO 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 CO. 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.

9. 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/designee shall meet with the contractor as needed to assess performance and shall provide a written assessment.

10. PERFORMANCE REQUIREMENTS SUMMARY MATRIX

a. CPAR RATINGS ASSIGNED TO QASP ITEMS:

Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used (Reference: CPARS User Manual: https://www.cpars.gov/documents/CPARS-Guidance.pdf.

EXCEPTIONAL: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However, a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also, there should have been NO significant weaknesses identified.

VERY GOOD:

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also, there should have been NO significant weaknesses identified.

SATISFACTORY:

MARGINAL:

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g.

Management, Quality, Safety or Environmental Deficiency Report or letter).

UNSATISFACTOR Y:

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).

b. DOCUMENTING PERFORMANCE

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

ASSESSMENT REPORT (CPAR).

2. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the COR and the CO determines formal written communication is required, the COR shall prepare a Contract Report (CR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.

The contractor shall acknowledge receipt of the CR in writing. The CR 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 CR will also state how long after receipt the contractor has to present this corrective action plan to the CO.

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

Any CRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. See Sample on following page.

c. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASP

SIGNED:

COR NAME/TITLE DATE

SIGNED:

CONTRACTOR NAME/TITLE DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVIC

ES

QUANTIT

Y

UNI

T UNIT PRICE AMOUNT

0001 15.00 EA ________________

Initial/Pre-employment Psychological Evaluation Contract Period: Base POP Begin: 03-01-2027 POP End: 02-29-2028 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

0002 40.00 EA ________________

Periodic/Annual Psychological Evaluation Contract Period: Base POP Begin: 03-01-2027 POP End: 02-29-2028 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

0003 5.00 EA ________________

Directed/Special Fitness-for-Duty Psychological Evaluation Contract Period: Base POP Begin: 03-01-2027 POP End: 02-29-2028 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

1001 15.00 EA ________________

Initial/Pre-employment Psychological Evaluation Contract Period: Option 1 POP Begin: 03-01-2028 POP End: 02-28-2029 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

1002 40.00 EA ________________

Periodic/Annual Psychological Evaluation

Contract Period: Option 1 POP Begin: 03-01-2028 POP End: 02-28-2029 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

1003 5.00 EA ________________

Directed/Special Fitness-for-Duty Psychological Evaluation Contract Period: Option 1 POP Begin: 03-01-2028 POP End: 02-28-2029 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

2001 15.00 EA ________________

Initial/Pre-employment Psychological Evaluation Contract Period: Option 2 POP Begin: 03-01-2029 POP End: 02-28-2030 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

2002 40.00 EA ________________

Periodic/Annual Psychological Evaluation Contract Period: Option 2 POP Begin: 03-01-2029 POP End: 02-28-2030 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

2003 5.00 EA ________________

Directed/Special Fitness-for-Duty Psychological Evaluation Contract Period: Option 2 POP Begin: 03-01-2029 POP End: 02-28-2030 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

3001 15.00 EA ________________ ________________

Initial/Pre-employment Psychological Evaluation Contract Period: Option 3 POP Begin: 03-01-2030 POP End: 02-28-2031 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

3002 40.00 EA ________________

Periodic/Annual Psychological Evaluation Contract Period: Option 3 POP Begin: 03-01-2030 POP End: 02-28-2031 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

3003 5.00 EA ________________

Directed/Special Fitness-for-Duty Psychological Evaluation Contract Period: Option 3 POP Begin: 03-01-2030 POP End: 02-28-2031 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

4001 15.00 EA ________________

Initial/Pre-employment Psychological Evaluation Contract Period: Option 4 POP Begin: 03-01-2031 POP End: 02-29-2032 PRINCIPAL NAICS CODE: 621330 - Offices of Mental Health Practitioners (except Physicians) PRODUCT/SERVICE CODE: Q519 - Medical - Behavioral and Mental Health

4002 40.00 EA ________________

Periodic/Annual Psychological Evaluation Contract Period: Option 4 POP…