75H70526Q00019.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

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

OFFEROR

235CODE 16. ADMINISTERED BYCODE

X

X

334220

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR235

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

06/16/2026 1200 CT

06/01/2026

WINONA KITTO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70526Q00019

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 7OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Bemidji MN 56601

2225 Cooperative Ct NW, Rm 200

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

1,250

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

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Indian Health Service WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Bemidji MN 56601

2225 Cooperative Ct NW, Rm 200

Bemdiji Area Indian Health Service

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Satellite TV Services for the Red Lake Hospital

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

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

75H70526Q00019 Satellite TV Services

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

72 of

SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 CONTRACT ADMINISTRATION DATA

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

CONTRACTOR NAME AND ADDRESS:

EIN/TIN#_______________________________

UIE SAMS#_____________________________

CAGE#_________________________________

NAME:__________________________________

TELEPHONE:____________________________

EMAIL: _________________________________

DELIVERY ADDRESS:

Red Lake Hospital 24760 Hospital Drive Red Lake, MN 56671

CONTRACTOR REGISTRATION: All required information must be in the System for Award Management (SAM) at www.sam.gov.

GOVERNMENT:

Winona Kitto Jennifer Richardson Indian Health Service Indian Health Service 2225 Cooperative Ct NW, Rm 202 2225 Cooperative Ct NW, Rm 202 Bemidji, MN 56601 Bemidji, MN 56601 Winona.kitto@ihs.gov Jennifer.richardson@ihs.gov

The associated North American Industrial Classification System (NAICS) code: 334220 – Radio and Television Broadcasting and Wireless Communications Equipment Manufacturing

PSC: 5820 – Radio and Television Communication Equipment

CONTRACT TYPE: Firm-Fixed Price

INVOICES: In accordance with the Prompt Payment Act, payment will be due 30 days after receipt of services or receipt of a proper invoice, whichever is later.

mailto:Winona.kitto@ihs.gov mailto:Jennifer.richardson@ihs.gov

INVOICE INSTRUCTIONS:

Electronic Invoicing and Payment Requirements - Invoice Processing Platform (IPP) Payment requests must be submitted electronically through the U. S. Department of the Treasury's Invoice Processing Platform System (IPP).

"Payment request" means any request for contract financing payment or invoice payment by the Contractor. To constitute a proper invoice, the payment request must comply with the requirements identified in the applicable Prompt Payment clause included in the contract, or the clause 52.212-4 Contract Terms and Conditions - Commercial Items included in commercial item contracts. The IPP website address is: https://www.ipp.gov.

Under this contract, the following documents are required to be submitted as an attachment to the IPP invoice:

- A copy of the Contractor's invoice shall be included with the IPP invoice. If no invoice is attached, the Invoice will be rejected;

- Contractor's Invoice shall contain:

* Contract number

* SAM's Registration - Unique Identity Number (UEI Number)

* EIN or Tax ID Number

* List of deliverables;

- Timesheets if applicable - Number of hours worked with corresponding labor category and rate

HHSAR 352.232-71 Electronic Submission of Invoice Payment Requests (Feb 2022)

(a) Definitions.

Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), "Content of Invoices" and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system. Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request.

Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

Improperly prepared invoices or statements shall be returned to the contractor and may delay payment.

BID SCHEDULE – Base plus 4 Option Years

DESCRIPTION QUANTITY UNIT OF

ISSUE

UNIT

PRICE

TOTAL

DIRECTV Services or Equivalent – Base Year

12 Months $ $

Option Year 1 12 Months $ $ Option Year 2 12 Months $ $ Option Year 3 12 Months $ $ Option Year 4 12 Months $ $

Grand Total: $

Statement of Work

For Satellite TV Services at the Red Lake Hospital

A. BACKGROUND INFORMATION

The Red Lake Service Unit currently obtains cable services from the local telephone company, which has served the hospital for many years. Since Red Lake is in a Rural location, it is hard to get service for things up here.

B. PURPOSE AND OBJECTIVES OF THE ACQUISITION

TV Services are vital to the delivery of direct inpatient care, to provide educational information, to enhance satisfaction, and to promote patient comfort.

C. CONTRACTOR REQUIREMENTS

The contractor will be responsible for mounting the DIRECTV or equivalent dish on the roof utilizing non-penetrating mounts, running backbone cabling from the dish to the main distribution point, taking over the existing cabling distribution, and installing a 23 Channel HD COM 3000 System with Transcoder and connecting to the existing coax distribution system.

The contractor will be responsible for addressing any issues that arise with the service during the contract.

D. GOVERNMENT RESPONSIBILITIES

When the Red Lake Hospital experiences problems with DIRECTV or equivalent, the COR will contact the contractor to have the issue resolved in a timely manner, unless it’s weather-related.

REPORTING REQUIREMENTS AND DELIVERABLES

F. INSPECTION AND ACCEPTANCE REQUIREMENTS

The IT Manager or the Facilities Manager will inspect and accept all work completed within the facility, provided it meets requirements.

FEDERAL ACQUISITION REGULATIONS

52.252-2 Clauses Incorporated by Reference.

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

www.acquisition.gov

52.204-7 System for Award Management 52.204-13 System for Award Management Maintenance.

52.204-19 Incorporation by Reference of Representations and Certifications.

52.209-10 Prohibition on Contracting with Inverted Domestic Corporations 52.212-4 Contract Terms and Conditions—Commercial Products and Commercial Services 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders—

Commercial Products and Commercial Services 52.217-8 Option to Extend Services.

52.217-9 (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

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

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 5 (years).

52.222-90 Addressing DEI Discrimination by Federal Contractors 52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving 52.224-1 Privacy Act Notification 52.224-2 Privacy Act.

52.232-1 Payments.

http://www.acquisition.gov/

HEALTH & HUMAN SERVICES ACQUISTION REGULATION (HHSAR) CLAUSES:

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.hhs.gov/policies/hhsar/subpart301-1.html

HHSAR Provisions and Clauses:

352.224-70 Privacy Act.

352.226-1 Indian Preference.

352.237-70 Pro-Children Act.

352.237-74 Non-Discrimination in Service Delivery.

352.239-73 Electronic Information and Technology Accessibility Notice 352.239-74 Electronic and Information Technology Accessibility http://www.hhs.gov/policies/hhsar/subpart301-1.html