Sol_75H71023Q00015_Amd_0001.pdf

(x)

75H71023Q00015 x x 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 ACKNOWLEDGEMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY 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.

x

Gallup NM 87301 1808 W. Aztec Avenue Acquisition Department Gallup Indian Medical Center

12/20/20220001

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

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: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

12/13/2022

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of Amendment 0001 is as follows:

1. To provide questions and answers.

2. Change the Contracting Officer from Jericho Lewis to Misty Billy

1 Non-personal Health Care Services for (5) Board

Certified/Board Eligible Emergency Medicine

Physicians.

Hours: 520

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

MISTY J. BILLY

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 4

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H71023Q00015/0001

The Contractor shall provide required services

IAW Attachment A - Performance Work Statement.

This is a Labor-Hour CLIN. Values are estimated.

Contractor exceeds value at its own risk.

2 Non-personal Health Care Services for (5) Board

Certified/Board Eligible Emergency Medicine

Physicians.

Hours: 520

The Contractor shall provide required services

IAW Attachment A - Performance Work Statement.

This is a Labor-Hour CLIN. Values are estimated.

Contractor exceeds value at its own risk.

(Option Line Item)

06/30/2023

Period of Performance: 04/01/2023 to 06/30/2023

3 Non-personal Health Care Services for (5) Board

Certified/Board Eligible Emergency Medicine

Physicians.

Hours: 520

The Contractor shall provide required services

IAW Attachment A - Performance Work Statement.

This is a Labor-Hour CLIN. Values are estimated.

Contractor exceeds value at its own risk.

(Option Line Item)

09/30/2023

Period of Performance: 07/01/2023 to 09/30/2023

4 Non-personal Health Care Services for (5) Board

Certified/Board Eligible Emergency Medicine

Physicians.

Hours: 520

The Contractor shall provide required services

IAW Attachment A - Performance Work Statement.

This is a Labor-Hour CLIN. Values are estimated.

Contractor exceeds value at its own risk.

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 4

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H71023Q00015/0001

(Option Line Item)

12/31/2023

Period of Performance: 10/01/2023 to 12/31/2023

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

Questions for Solicitation 75H71023Q00015

Responses to questions from Dr. Paul Charlton, GIMC ED Director.

1. What is the annual volume?

45,000/year

2. What is the trauma designation?

Level 3

3. Will this be single or double coverage?

Double

4. What support staff is available in the ER?

ED Health technicians, Nursing Assistants, Respiratory Therapists, nurses

5. Who does the admissions?

Dedicated hospitalists and surgeons.

6. Will these be 12 hour shifts?

No, shifts are generally 10 hours for contractors.

7. How many visits per day, per year?

Daily patient volume varies between 110 – 180 patients. Annual volume ~45,000/year.

8. Are there 5 FTE open slots or is this “up to 5FTE slots”?

There are 5 FTE slots open.

9. Are these 12hr block schedules? How long are the blocks 7 shifts in row?

We generally do not have 12 hour shifts for contractors; most shifts are 10 hours. For contractors who wish to block their shifts together, we are generally flexible to try to work with the specific contractor’s preferences regarding how many days in a row they work. If someone chose to work 7 shifts in a row, each of those shifts would be 10 hours.

10. What is the max # of 12hr shifts in a row?

We generally don’t schedule contractors for 12 hour shifts. Very rarely there is a single weekend day (perhaps once every month) that a provider may need to work a 12 hour shift but we almost always have that shift covered by an employee physician.