Sources_Sought_Questionnaire_for_Maritime_Medical_(14Feb14)_posted_to_FBO.doc

SOURCES SOUGHT QUESTIONNAIRE

Company Name: ______________________________________________________________________

Point of Contract (Name & Position): _____________________________________________________

Mailing Address:

Phone: _______________ Fax: _________________ Email: ______________________ DUNS Number: ______________________ CAGE Code: ______________________

NOTE: The Government will not publish responses outside the National Oceanic and Atmospheric Administration (NOAA), Western Acquisition Division (WAD)—Seattle office; it will use information collected as a tool for the upcoming acquisition. Please submit your responses no later than 26 February 2014 by 2:00:00 PM (PST) via email or facsimile to Angela Royster, angela.royster@noaa.gov, fax number (206) 527-0335.

1. Is your company registered with the System for Award Management (SAM) website (https://www.sam.gov)?

[ ] yes [ ] no

2. Is your firm eligible for participation in one of the following small business programs? If so, please indicate the program.

[ ] yes [ ] no Small Business (SB) [ ] yes [ ] no Historically Underutilized Business Zone (HUBZone) [ ] yes [ ] no Small Business 8(a) [ ] yes [ ] no Small Disadvantaged Business (SDB) [ ] yes [ ] no Economically-Disadvantaged Women-Owned Small Business (EDWOSB) [ ] yes [ ] no Women-Owned Small Business (WOSB) [ ] yes [ ] no Service-Disabled Veteran-Owned Small Business (SDVOSB) [ ] yes [ ] no Veteran-Owned Small Business (VOSB) [ ] yes [ ] no Other (please specify)

3. If the Government selected your firm, how many calendar days would your firm need after contract award date before you could completely setup and begin providing services?

[ ] Immediately [ ] 10 days [ ] 15 days [ ] 30 days [ ] Other ____________

4. What is the commercial standard in your industry regarding the frequency of invoicing for the required services?

[ ] Monthly [ ] Quarterly [ ] Other ____________

5. Is your firm currently providing similar services under any other Government contract(s) (including General Services Administration, aka GSA)? If so, please provide the contract number, Government agency, a Government point of contact, and a brief description of services for each.

6. Does your firm and/or subcontractor(s), partner(s), etc. have experience and/or capability providing the following:

a) Medical director and emergency physician services, to include Board certification (American Board of Medical Specialties) and one year maritime medicine experience, as per draft PWS paragraph 3.? Please describe.

Experience:_______________________________________________________________________ Capability:________________________________________________________________________

b) Providing and maintaining an emergency telephone line with one or more board certified emergency physicians with maritime medicine experience (attending) to respond immediately to requests for medical advice calls on a 24 hours a day, seven-days a week (24/7) basis, as per draft PWS paragraph 2.1.1.? The contractor shall note that ships may be 3,000 plus miles out at sea with the nearest evacuation point a 2-3 day sail away and that the emergency phone line shall have the capacity to meet all requirements of the PWS. Please describe.

Experience:_______________________________________________________________________ Capability:________________________________________________________________________

c) Evaluation(s) of medical care provided by NPs, PAs, and RNs on a regular periodic basis for comments that address the quality of documentation provided, the degree to which the medical standard of care was met, other considerations in the differential diagnoses or in the physical exam, and other pertinent instructions, recommendations, or guidance that would improve the patient care or outcome (as per PWS paragraph 2.2.2.)?

Experience:_______________________________________________________________________ Capability:________________________________________________________________________

d) Reviews of individualized patient fitness for duty evaluations and making recommendations regarding employees’ fitness for duty status, as per draft PWS paragraph 2.3.? Please describe.

Experience:_______________________________________________________________________ Capability:________________________________________________________________________

7. Please provide comments regarding the draft PWS, and any deviation(s) from commercial practices that may be included:

8. Provide any additional feedback that you feel is relevant (e.g., problems or any other issues experienced with similar contracts):

Again, we thank you for taking the time to assist us in gathering this information!