9594CS22Q0062 Amendment 003 - 8-15-22.pdf

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 items 8 and 15, and returning or (c) By separate letter or telegram 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 RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

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

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

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

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

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION

NO.

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE 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.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

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.

15C. DATE SIGNED

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

16C. DATE SIGNED

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

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

PAGE OF PAGES

6. ISSUED BY CODE

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

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable

See the attached Page 2

Court Services and Offender Supervision Agency Office of Procurement 800 N. Capitol Street, Suite 6119 Washington, DC 20002-4260 POC: William Hall; 202-220-5717; william.hall@csosa.gov

RSC220013

9594CS22Q0062

1 2

08/15/2022

07/20/2022

RSC Medical Services 9594CS22Q0062 Amendment 003

1. This Amendment 003 is being issued to replace the Past Performance Questionnaire provided with the Solicitation and marked as Attachment J-3 with the correct Attachment J-9 Past Performance Questionnaire (Attached).

2. There are no other changes to the solicitation.

Attachment J-9

Past Performance Questionnaire

PLEASE EMAIL THE COMPLETED QUESTIONNAIRE NO LATER THAN, August 17, 2022, 12:00 PM (local Washington, DC ) time TO: William.hall@csosa.gov and Catherine.collins@csosa.gov.

1. The Contractor in A below has identified the Questionnaire Respondent as someone for whom the Contractor provided a service similar to the service requirement in paragraph 2.

2. The Contractor is submitting a proposal to the Court Service and Offender Supervision Agency (CSOSA) to provide the following: A full range of medical services utilizing a Physician, Psychiatrist, Physician Assistant, Registered Nurse, and Medical Records Clerk.

3. This Questionnaire should be completed by the individual most knowledgeable of the Contractor’s day-to-day operations and overall condition of the supplies/services provided under the referenced contract. However, that individual is encouraged to supplement their knowledge of the Contractor’s performance with the judgement and observations of others within their organization, as applicable.

4. Handwritten responses are sufficient, however, please ensure they are legible.

5. Please provide explanatory narratives for as many responses as possible. These narratives need not be lengthy, just descriptive. Space for narrative comments is included on the last page of the questionnaire. If more space is required, additional pages may be added to this questionnaire. Please clearly identify which evaluation factor a narrative applies to.

As this questionnaire relates to an ongoing source selection for “Medical Services”, we request that all information provided in this questionnaire be safeguarded against unauthorized disclosure.

A. CONTRACTOR INFORMATION: (Contractor requesting reference complete Section A)

Contractor Name: _________________________________________________________________

Reference Contract Number: ________________________________________________________

Project Title or Brief Description of the Medical Services Provided by the Contractor under the

Reference Contract: ___________________________________________________________________

Note: If the Contractor holds, or has held, other contracts with your agency/organization in the last 3 years, please complete a separate questionnaire for each of those contracts.

mailto:William.hall@csosa.gov mailto:%20Catherine.collins@csosa.gov

B. QUESTIONNAIRE RESPONDENT INFORMATION:

Respondent Name: ___________________________ Title: __________________________________

Respondent’s Phone #: ________________________ Email: __________________________________

Respondent’s Company Name: __________________________________________________________

Company Address: ____________________________________________________________________

CONTRACT PERFORMANCE INFORMATION:

1. What was the period of performance start and end dates for the Reference Contract:

From: _______________________ To: ___________________________

2. What was the total value of the Reference Contract? __________________________

3. In what capacity did the Contractor provide supplies/services to under the Reference

Contract? Prime Contractor ______ Subcontractor ______ Key Person ________

4. Please use the following Performance Scale to rate the Contractor’s performance on the

Reference Contract, where a 6 is Exceptional and a 1 is Neutral. Please place the number that corresponds with the level of performance that you experienced/observed in the box on the right side of the performance criteria.

5. Please provide a narrative explanation for any ratings of 1, 2 or 3.

Performance Scale

SCHEDULE RATING

1 Contractor’s responsiveness/timeliness in providing the required services.

2 Contractor’s responsiveness/timeliness to administrative functions of the contract.

3 Contractor’s responsiveness/timeliness in responding to questions or correspondence.

4 Contractor’s compliance with contract terms and conditions.

5 Were any contract concessions, changes, or terminations made due to the contractor’s failure to accurately plan?

MANAGEMENT OF KEY PERSONNEL RATING

6 Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period?

7 Contractor's preparation & training of personnel 8 Contractor's ability to effectively manage subordinates.

6 Exceptional

Performance meets contractual requirements with many exceeded to the benefit of the Government or client (if a non-Government contract). The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

5 Good

Performance meets contractual requirements with some exceeded to the benefit of the Government or client (if a non-Government contract). The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

4 Satisfactory 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 were satisfactory.

3 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 yete identified corrective actions or the contractor's proposed actions appearonly marginally effective or were not satisfactory.

2 Unsatisfactory 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 contains a serious problem for which the contractor's corrective actions appear, or were ineffective.

1 Neutral Performance was not observed or not applicable to the current effort being reported against

QUALITY OF SERVICES RATING

9 Provided effective quality control and/or inspection procedures to meet contract requirements.

10 Followed the approved quality control plan.

11 Corrected deficiencies in a timely manner and pursuant to the quality control procedures.

12 Provided timely resolution of contract discrepancies.

13 Suggested alternative approaches to problem solution.

14 Displayed initiative to identify and solve problems as they occurred.

17 Demonstrated ability to assimilate & accommodate changes in contractual requirements and/or priorities.

18 Exhibited knowledge of, and compliance with, Government (or other) rules and regulations.

19 Demonstration of technical expertise in providing all contracted services.

20 Possessed and utilized the tools and equipment necessary to adequately provide the required services.

21 Accomplishment in meeting the quality standards specified for:

a. Technical Performance

b. Administrative Performance

c. Safety & Health

22 Did the Contractor ever fail to effectively control the quality of services provided? If Yes, please explain in the Narrative Remarks section below.

23 Was a Contract Discrepancy Report, or equivalent, ever issued? If Yes, please explain in the Narrative Remarks section below.

24 Was a Cure Notice or Show Cause Letter ever issued? If Yes, please explain in the Narrative Remarks section below.

25 Were there any disputes/claims relative to the contract? If Yes, please explain in the Narrative Remarks section below.

26 Has Contractor demonstrated the ability to correct any of the problems identified in 22, 23, 24 or 25 above? If Yes, please explain in the Narrative Remarks section below.

27 Has this Contractor ever been terminated for default? If Yes, please explain in the Narrative Remarks section below.

28 Has an election ever been made to not exercise an option due to the Contractor's poor performance? If Yes, please explain in the Narrative Remarks section below.

BUSINESS RELATIONS RATING

29 Contractor's management of subcontractors.

30 Have there been any labor disputes? If Yes, please explain in the Narrative Remarks section below.

31 Have there been any violations of Public Law, especially the Service Contract Act? If Yes, please explain in the Narrative Remarks section below.

32 Contractor's ability/willingness to consistently provide prompt and courteous service.

33 Contractor's ability/willingness to promptly and courteously resolve customer complaints.

34 Contractor's overall commitment to customer satisfaction.

35 Contractor's overall cooperation relative to the contract.

36 How would you rate the integration and coordination of all activity needed to perform this contract?

37 How would you rate the Contractor's overall performance?

38 Would you award another contract to this Contractor? If Not, please explain in the Narrative Remarks section below.

Narrative Remarks: (Please include the corresponding question # in the remark):